Claims & Billing Specialist

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

WHAT YOU’LL DO:

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 by

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

WHO YOU ARE:

Our Navigation Operations is a fast-paced, dynamic, and growing environment.  We are looking for individuals who are passionate about concierge service delivery and changing the healthcare experience for consumers.

Strong communication skills, both written and verbal

Professional experience with both 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 and minimum of 2 years of experience as a medical claims specialist preferred

COMPENSATION: $19.00 - $23.00/hr

Compensation offered will be determined by geographic location, experience, and qualifications.