Claims & Billing Specialist

About the role

This role is located in our Denver Tech Center Office. This is not a remote position.

Responsibilities

• Determines coverage for medical, dental, and vision procedures by studying provisions of the member’s health policy
• Extracts additional information as required from outside sources, including claimant, physician, employer, hospital, insurance carriers, and other third partners
• Initiates investigation of questionable claims
• Resolves medical, dental, and vision claims and billing questions and issues
• Provides information on year-to-date deductible, copay, and coinsurance activity to team members
• Maintains quality customer service by following customer service practices and responding to customer inquiries in a timely manner
• Protects claimant information by following HIPAA guidelines
• Reports claim status updates in proprietary CRM and provides detailed information on each claim

Requirements

• Passionate about concierge service delivery and changing the healthcare experience for consumers
• Strong communication skills, both written and verbal
• Professional experience with benefit plan interpretation, provider billing practices, and claim adjudication
• Strong demonstration of critical thinking and problem-solving skills
• Bachelor’s degree in health sciences or related field
• Minimum of 2 years of experience as a medical claims specialist preferred

Pay

$19.00 - $23.00/hr (compensation determined by geographic location, experience, and qualifications)