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Anderson Merchandisers
Plano, TX, United States
WE ARE LOOKING FOR GREAT PEOPLE TO JOIN OUR TEAM- just like you! Our associates have a lot in common. They have great interpersonal skills, enjoy working independently, are self-motivated, and have a relentless drive. Did we mention that while they are working hard, they also like to have fun? We offer flexible hours, competitive pay, and great b
Job Source: Anderson MerchandisersZelis Healthcare, LLC
Plano, TX, United States
Position Overview: The Claims Settlement Specialist supports claim settlement with providers through post payment negotiation. The Claims Settlement Specialist will be responsible for handling provider telephone calls regarding the payment amount paid to a provider by a payor based on Zelis data points. During this call, the Claims Settlement Speci
Job Source: Zelis Healthcare, LLCMarsh McLennan Agency
Dallas, TX, United States
For this role, we are looking to hire a Sr. level specialist if the right candidate is found. SUMMARY: As a Claims Specialist for the Marsh McLennan Agency, you will be a claims consultant providing oversight and advocacy on behalf of our clients throughout the process of a loss event and the life of a claim. Duties include: You will submit claims
Job Source: Marsh McLennan AgencyAcosta Sales & Marketing
Irving, TX, United States
DESCRIPTION The Claims Resolution Specialist is responsible for validating and clearing claims against promotional offers, analyzing claims to determine their validity, and clearing claims in accordance with Acosta, client and customer policies and procedures. The Claims Resolution Specialist will communicate with internal and external business par
Job Source: Acosta Sales & MarketingAmTrust Financial
Dallas, TX, United States
Claims Data & Analytics Specialist Job Locations US-United States Requisition ID 2024-16563 Category Analytics Position Type Regular Full-Time Overview The Claims Data & Analytics Specialist is responsible for supporting the Claims organization by providing analytics and reporting to identify opportunities to improve efficiency and effec
Job Source: AmTrust FinancialINSHUR
Irving, TX, United States
We are looking for a Claim Specialist II (CS2) here at INSHUR. You'll be working on re-inventing insurance in exciting markets across multiple territories, including the US, UK, and the Netherlands, and new European countries and US states as we expand. Supported by (and reporting to) Chanel Jones, Cynthia Barrios, and Kristi Thompson, you'll be j
Job Source: INSHURAmTrust Financial
Dallas, TX, United States
Claims Predictive Analytics Specialist Job Locations US-United States Requisition ID 2024-17050 Category Analytics Position Type Regular Full-Time Overview The Claims Predictive Analytics Specialist will examine claims and other data sources to detect potentially fraudulent activity. They will conduct extensive research from both interna
Job Source: AmTrust FinancialINSHUR
Irving, TX, United States
We are looking for a Claim Specialist II (CS2) here at INSHUR. You'll be working on re-inventing insurance in exciting markets across multiple territories, including the US, UK, and the Netherlands, and new European countries and US states as we expand. Supported by (and reporting to) Chanel Jones, Cynthia Barrios, and Kristi Thompson, you'll be j
Job Source: INSHURDallas, TX, United States
Job Overview
The Provider Communication Claim Specialist is pivotal in facilitating communication between external providers and internal stakeholders regarding the status and resolution of claims. This role requires the ability to research and identify root causes of claim issues and effectively convey this information in a positive and professional manner to providers. The Specialist plays a critical role in maintaining positive relationships with providers through clear and accurate communication, ensuring timely resolution of claim inquiries and issues.
THIS POSITION IS 100% ONSITE. We are located in Dallas, TX.
Responsibilities and Duties
Communicate effectively with external healthcare providers and internal teams to provide accurate and timely updates on claim status and resolution.
Research and analyze claim data to determine root causes of claim issues and discrepancies.
Utilize critical thinking skills to identify trends or recurring issues in claims processing and recommend solutions for improvement.
Maintain organized documentation of communications and resolutions using Excel, Word, Outlook, and SharePoint.
Collaborate within a team environment while also demonstrating the ability to work independently to address provider inquiries and escalations.
Uphold motivation and accountability to complete tasks efficiently and accurately without immediate supervision.
Achieve a typing speed of at least 50 words per minute to facilitate efficient documentation and correspondence.
Qualifications
Bachelor's degree preferred, preferably in Healthcare Administration or a related field.
Proficiency in Microsoft Office applications (Excel, Word, Outlook) and SharePoint.
Strong understanding of medical billing processes and Medicare guidelines.
Ability to research and comprehend complex medical contracts and claim information.
Excellent verbal and written communication skills with a customer service-oriented approach.
Demonstrated ability to analyze and interpret data to resolve issues effectively.
Exceptional organizational skills with attention to detail to maintain accurate records and documentation.
Capability to thrive in a fast-paced environment, managing multiple priorities with professionalism and efficiency.
Proven ability to work collaboratively within a team environment while also excelling as an independent contributor.
Work Environment
Fast-paced office setting within a healthcare claims and communication department.
Regular use of computer and software applications for data analysis, communication, and documentation.
Interaction with both internal teams and external healthcare providers to facilitate efficient claim resolution and communication.
Benefits
Medical Insurance
Dental Insurance
Vision Insurance
Short & Long Term Disability
Life Insurance
401k with company match
Paid Time Off
Paid Parental Leave
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Email Alert for Provider Communication Claim Specialist jobs in Dallas, TX, United States
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