Insurance Claims Specialist
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It says e.g., implying those are examples but we should likely stick to those. Safer to use those headings only. So we can put agency description under About the role.
We need to include all substantive info: job description, responsibilities, minimum qualifications, preferred qualifications, additional requirements (education verification, TB test, etc), pay, schedule (including telework details), benefits.
We must not include application instructions, contact info, etc. Also remove EEO boilerplate, etc.
We need to preserve all substantive information; do not invent or summarize away detail. So we must keep the exact wording? Probably we can keep the substance but not necessarily verbatim; but better to keep as is.
We need to output only HTML fragment, no /, no markdown fences.
Let's structure:
About the role
Direct Care & Treatment (DCT) is seeking an individual to join our DCT Finance team for an exciting opportunity as an Insurance Claims Specialist. As the Insurance Claims Specialist, you will secure reimbursement for treatment provided to individuals at State facilities. DCT operates treatment programs, residential and vocational services for people with serious mental illness, developmental disabilities, substance use disorders and more. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities. This position requires an employee to be onsite at 3200 Labore Rd, Ste 104, Vadnais Heights, Minnesota at least 50% of the time, with some opportunity to perform work from a telework location. Telework is available on a limited basis. Only candidates residing in Minnesota or a state bordering Minnesota (Iowa, North Dakota, South Dakota, or Wisconsin) within 50 miles of the work address listed above are eligible for telework. Candidates residing in Minnesota and more than 50 miles from the primary/principal work address above may be eligible to telework more than 50%. Direct Care & Treatment (DCT) is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DCT does not participate in E-Verify.
But note we must not include boilerplate like EEO etc. The above includes some generic statements about equity etc. That's from the posting; it's substantive? It's part of the "The work you'll do is more than just a job..." paragraph. That's okay. Now Responsibilities:Responsibilities
- Confirm insurance eligibility and benefit verification and ensure timely claim submission of inpatient and outpatient mental health, chemical dependency, residential, vocational and foster care, primary care and dental services.
- Review, research and correct demographic discrepancies and/or insurance coverage in the Practice Management System (PM) to ensure timely claim processing and payment.
- Review aged and unpaid claims. Analyze research and navigate payer specific coverage and reimbursement policies and/or submit coding reviews to resolve billing discrepancies in a timely manner.
Requirements
Minimum Qualifications: One (1) year of experience managing insurance claims in a healthcare setting. Experience must include the following:
- Experience with accounting principles, practices, and procedures
- Experience in revenue cycle, medical billing, processing claim submissions, and analyzing insurance coverage
- Experience analyzing data, reports and interpreting records to identify and resolve discrepancies
- Experience using Microsoft Office Excel sufficient to create and maintain databases and spreadsheets, and to create and use formulas and queries to produce desired results
- Analytical and organizational skills to conduct research, interpret and understand relevant MN statutes, policies, contracts, guidelines, rules and regulations.
OR Three (3) years of administrative support experience supporting insurance claims management in a healthcare setting. Experience must include the following:
- Experience with accounting principles, practices, and procedures
- Experience supporting revenue cycle, medical billing, reviewing claim submissions, and understanding insurance coverage and inquiries
- Experience using Microsoft Office Excel sufficient to maintain databases and spreadsheets
Note: A bachelor’s degree in Business Administration, Accounting, Finance or related degree may substitute for 1 year of administrative support experience.
Now Qualifications:Qualifications
Preferred Qualifications:
- Experience with Inpatient Psych, Inpatient Residential and Outpatient Mental Health.
- Experience with Medicare and Medicaid billing.
- Two (2) – five (5) years of experience in revenue cycle, medical billing, processing claim submissions, and analyzing insurance coverage.
- Our employees are dedicated to ensuring cultural responsiveness. Preferred candidates will have a variety of experiences working effectively with others from different backgrounds and cultures.
Additional Requirements
but not in allowed list. Might be okay to add but instruction says use h3 for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). It doesn't forbid other headings, but says use h3 for section headings (e.g. those). Safer to stick to those. So we can incorporate Additional Requirements into Requirements or Qualifications. Let's put them under Requirements after the qualifications. Add:Additional Requirements:
- To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates each job's beginning and ending month and year.
- REFERENCE/BACKGROUND CHECKS – Direct Care & Treatment will conduct reference checks to verify job-related credentials and criminal background check prior to appointment.
- EDUCATION VERIFICATION - Applicants will be required to provide a copy of their high school diploma at time of interview OR copies of their college transcript or college degree/diploma at time of interview. Copies of the college degree/diploma are acceptable ONLY if it clearly identifies the field in which it was earned.
- Direct Care & Treatment (DCT) healthcare facilities require employees to provide documentation that they are free from tuberculosis (TB) through a blood test prior to employment. DCT does not accept TB skin testing.
Pay
Salary Range: $26.12 - $37.91 / hourly; $54,538 - $79,156 / annually
Schedule:Schedule
Work Shift/Work Hours: Day Shift
Days of Work: Monday - Friday
Telework Eligible: Yes. This position requires an employee to be onsite at 3200 Labore Rd, Ste 104, Vadnais Heights, Minnesota at least 50% of the time, with some opportunity to perform work from a telework location. Telework is available on a limited basis. Only candidates residing in Minnesota or a state bordering Minnesota (Iowa, North Dakota, South Dakota, or Wisconsin) within 50 miles of the work address listed above are eligible for telework. Candidates residing in Minnesota and more than 50 miles from the primary/principal work address above may be eligible to telework more than 50%.
Benefits: We have a Benefits paragraph with list. Let's capture:Benefits
- Paid vacation and sick leave
- 12 paid holidays each year
- Low-cost medical, dental, vision, and prescription drug plans
- Fertility care, including IVF
- Diabetes care
- Dental and orthodontic care for adults and children
- 6 weeks paid leave for parents of newborn or newly adopted children
- Pension plan that provides income when you retire (after working at least three years)
- Employer paid life insurance to provide support for your family in the event of death
- Short-term and long-term disability insurance that can provide income if you are unable to work due to illness or injury
- Tax-free expense accounts for health, dental, and dependent care
- Resources that provide support and promote physical, emotional, social, and financial well-being
- Support To Help You Reach Your Career Goals: Training, classes, and professional development
- Federal Public Service Loan Forgiveness Program (Some positions may qualify for the Public Service Loan Forgiveness Program. For more information, visit the Federal Student Aid website at studentaid.gov)
- Employee Assistance Program (EAP) For Work/life Support: A voluntary confidential program that helps employees and their families with life challenges that may impact overall health, personal well-being, or job performance. Common sources of stress can be addressed through the EAP: mental health, relationship challenges (personal and work), grief and loss, finances, and legal issues
- Daily Living/Convenience Services: Chore services, home repair, trip planning,