Claims Intake Specialist

About the role

This is a hybrid position with 3 days in-office. Applicants must be authorized to work for ANY employer in the U.S. We do not sponsor employment visas or other immigration processes to attain or maintain employment eligibility. Remote positions are open to applicants based anywhere in the continental U.S. Hybrid positions are open to applicants based in the Austin, Texas area.

Responsibilities

• Obtain pertinent information from new claimants by performing telephonic interviews and/or requesting claimant statements via email.
• Manage all requests by telephone and email, coordinate with clinical staff and claim eligibility specialists to ensure accuracy while providing support to both internal and external customers.
• Provide policy and claim information, assists with submission of claims and make outbound calls to gather missing information when incomplete documentation is received.
• Conduct research when needed to resolve customer questions or complaints.
• Manage outbound calls and letters to customers and providers to research incomplete claims
• Process paperwork for new claimants efficiently and in accordance with department procedures.
• Document pertinent claim information and call summaries in the claim system and other applications.
• Contribute ideas to the team that enhance service quality.
• Comply with HIPAA and other regulatory requirements
• Perform project work and other related duties as assigned or required.

Qualifications

• A High School Diploma or equivalent.
• A background in Healthcare Administration, Long Term Care or Health claims, or 2 years of insurance industry customer service.
• Ability to communicate clearly and effectively, both verbally and in writing.
• Ability to handle customer interactions in a calm, professional, friendly and patient manner.
• Ability to work independently and utilize professional judgement to make accurate determinations and efficiently manage a multi-claim inquiry caseload.
• Ability to quickly adapt to changes either within the department or during the daily work assignments.
• Excellent organizational and time management skills.
• Attention to detail.
• Ability to work in a team environment and display a positive attitude in an effort to meet department goals.
• Ability to work within a Windows Operating system and Microsoft Office Products.

Benefits

• Competitive Salary & Target Bonus Program
• Retirement Savings – 401(k) with a company match
• Comprehensive Medical insurance through BlueCross BlueShield of Texas. Company paid dental, vision, short-term & long-term disability, and life insurance.
• Work-Life Balance – This role offers 20+ days of PTO, 10 paid holidays, and paid volunteer time off.
• Flexible Work Options & Perks – Hybrid opportunity, wellness programs, and weekly paid lunch for onsite staff.
• Health Savings Accounts (HSA) & Flexible Spending Accounts (FSAs) – Includes a company match for HSAs.