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Claims Management Specialist at Experity, Inc in Sioux Falls, South Dakota

Posted in Admin - Clerical 30+ days ago.

This job brought to you by eQuest

Type: Full-Time

Job Description:

Your next steps:
All applicants applying for this position must successfully complete our assessment first to be considered for a phone interview.     Assessment link:

• Manages electronic clearinghouse to ensure claims are corrected and submitted daily and enrollments are in place for assigned clinics.
• Supervises the efficiency of the electronic data exchange to ensure claims are corrected and submitted daily and required enrollments are in place.
• Ability to work rejected unresolved claim issues and report trends to supervisor and client success manager.
• Communicates with internal and external customers via phone calls and written communications as needed.
• Expert in recognizing problems effectively and researching the resolution.
• Ability to solve the detected issues within the given time requirements.
• Flexible with learning new tools and processes whenever required.
• Set up insurance website access for Experity users and clients and maintain updated login information.
• Manages a shared email box for all of RCM client requests from internal and external stakeholders.
• Set up electronic funds transfer, update bank information and send out payer notifications to optimize cash flow for all clients.
• Provides support for Claims Management Supervisor.
• Researches, records findings, and communicates effectively with Supervisor to achieve optimum performance.
• Maintains patient confidence and protects medical office operations by keeping patient information confidential.
• Contributes to team effort by accomplishing related results as needed.
• Other duties as assigned

• Minimum of two years of related experience in a business, medical or technical environment
• Previous experience in a medical office setting and/or experience with an Electronic Medical Record software

Education and Experience:
• High school diploma or equivalent is required.

• Customer service driven
• Understanding of medical terminology and insurance laws/guidelines.
• Excellent organization and time management skills along with excellent oral and written communication skills
• Strong team player
• Must enjoy participating in company-wide Wii bowling tournaments
• Proficient in Windows based applications, and MS Office software products
• Ability to learn quickly, build and maintain long term relationships and work with minimal supervision
• Strong written and verbal communication skills; strong analytical, organizational and time management skills required
• Expert analytical skills

Every team member exhibits our core values:
• Team First
• Lift Others Up
• Share Openly
• Set and Crush Goals
• Delight the Client

See job description