Claims Specialist

  • location: Nashville, TN
  • type: Contract
  • salary: $17 - $19 per hour
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job description

Claims Specialist

job summary:
Claims Specialist - Nashville, TN

  • This is one contract role expected to last 6 months.
Claims Specialist - Job Requirements:

  • Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement. Receives denied claims and researches appropriate appeal steps.
  • Collect required documentation, review file documentation, and make sure all items needed are requested. Ensure that all claim documentation is complete, accurate, and complies with company policy.
  • Establish, maintain, and update files, databases, records, and other documents for recurring internal reports. Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials Contact and communicate with clients by telephone, e-mail, or in-person.
Qualifications:

  • Basic knowledge in lending and the real estate industry. Excellent written and verbal communication. Strong attention to detail.
  • Ability to handle multiple tasks with frequent interruptions. Knowledge of basic accounting processes and procedures.
  • Basic computer skills including Microsoft Office.
  • Associate?s degree in billing, coding, business, finance or related field required; equivalent work experience may be substituted for education 2 to 5 years of experience required.
Compensation: $17-$19/hr

 
location: Nashville, Tennessee
job type: Contract
salary: $17 - 19 per hour
work hours: 9 to 5
education: Bachelor's degree
experience: 5 Years
 
responsibilities:
COB analysts are responsible for using established methods to investigate, verify, and record third party liability (TPL) coverage information on behalf of our Medicaid payer clients. COB analysts research TPL coverage leads through various methods including phone calls, correspondence, and online portals. COB Analysts maintain accurate TPL coverage to trigger appropriate cost-avoidance and recovery activities. COB analysts also respond to provider research requests and may be assigned other tasks as requested by management. COB analysts operate in a fast-paced, production environment and take ownership of their work product by understanding the value of timely, accurate TPL lead investigation.

Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement. Receives denied claims and researches appropriate appeal steps. Collect required documentation, review file documentation, and make sure all items needed are requested. Ensure that all claim documentation is complete, accurate, and complies with company policy. Establish, maintain, and update files, databases, records, and other documents for recurring internal reports. Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials Contact and communicate with clients by telephone, e-mail, or in-person.

 
qualifications:
Successful candidates will possess:

- Ability to adapt to the significant and frequent changes of the healthcare market

- Ability to work within a team environment with a positive attitude

- Strong investigative skills with detail orientation

- Strong multi-tasking ability

- Proficiency with time and workload management

- Very strong verbal and written communication skills

- Proficiency Microsoft Windows and Office products (esp. Word and Excel)

- Overtime may be required based on operational need

Job Requirements:

- Bachelor's degree or work experience with health insurance eligibility verification

- Background in government and/or commercial insurance healthcare coverage is a plus

- Must successfully pass a background check

 
skills: SAP, Excel
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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