Offer summary

Qualifications:

Proven experience in medical claims processing and management., Strong verbal communication skills with excellent English proficiency., Knowledge of HIPAA compliance and healthcare privacy requirements., Ability to work independently while maintaining clear communication..

Key responsabilities:

Manage and resolve denied insurance claims through systematic follow-up and appeals processes.

Conduct professional phone communications with various healthcare payers to expedite claim resolutions.

Analyse denial patterns and document causes to prevent future issues.

Collaborate with internal team members to optimize the claims management process.

Job description

This is a remote position.

Role Name: Claims Specialist

Schedule:

Part-time (15 hours per week, flexible scheduling , 5 hours per day for any 3 days between Monday-Thursday)

Client Time zone: US Central Time (CST)

Client Overview

Join a forward-thinking healthcare services organization that’s making a meaningful impact in the Minneapolis metropolitan area. This established company delivers essential health services to diverse communities while maintaining the highest standards of patient care. As part of their commitment to operational excellence, they’re seeking a detail-oriented professional to join their revenue cycle management team.

Job Description

Take ownership of a vital claims management process in a dynamic healthcare environment. This role offers the perfect blend of analytical problem-solving and interpersonal communication as you work with major healthcare payers to optimize claims processing and revenue recovery. You’ll have the opportunity to make an immediate impact by resolving complex claims issues while contributing to the organization’s long-term financial health. This flexible remote position allows you to balance work-life commitments while being part of an innovative healthcare team.

Responsibilities

Manage and resolve denied insurance claims through systematic follow-up and appeals processes
Conduct professional phone communications with various healthcare payers to expedite claim resolutions
Navigate multiple payer portals and systems to track and update claim statuses
Analyse denial patterns and document causes to prevent future issues
Maintain detailed records of all claims processing activities and outcomes
Track and report on claims success rates and key performance metrics
Collaborate with internal team members to optimize the claims management process
Ensure compliance with all healthcare regulations and privacy requirements

Requirements

Proven experience in medical claims processing and management
Strong verbal communication skills with excellent English proficiency
Demonstrated ability to navigate healthcare payer systems and portals
Experience with major payers such as UCare, Medica, and Health Partners preferred
Knowledge of HIPAA compliance and healthcare privacy requirements
Superior organizational and time management capabilities
Problem-solving mindset with attention to detail
Ability to work independently while maintaining clear communication
Proficiency in standard office software and claims management systems
Comfortable working remotely and managing priorities effectively
Professional demeanour when handling challenging situations