Aug 20, 2019
We are looking for a strong Medical Claims specialist for a growing and dynamic medical firm in the Tyler area. We are looking for someone who can process claims from start to finish and has at least 5 years of previous experience. Under the direction of the CFO, you will be responsible for working all insurance claims over 45 days and work all denied claims for Commercial, State Agency, and Worker's Compensation. Job Responsibilities & Duties • Examine claims records and forms to determine whether the patient has medical insurance. • Review provisions of certificate or policy to determine the patient's included medical coverage losses. • Negotiate claim settlements and make recommendations for legal action when settlements are deemed non-negotiable. • Complete logs, reports, forms and records to properly document medical claims. • Reject or accept documentation, determine benefits due, and start the denial or payment process to resolve medical claims. • Adhere to all company policies, procedures, and guidelines in addition to insurance regulations at the federal and state level. • Examine medical treatment records, police reports, physical property damage and medical bills to gauge the overall extent of liability. • Interview and communicate with claimants, police, witnesses, physicians and other necessary individuals to decide claim denial, settlement or review. • Ensure all claims information remains confidential. • Engage in continuing education and training opportunities when possible. Skills & Qualifications • At least a bachelor's degree • At least 5 years of experience working in the medical field • At least 5 years of experience as a medical claims specialist/examiner • Detail-oriented • Interpersonal skills • Analytical abilities • Data entry skills • Experience working with multiple insurance companies. Salary: $17.00 / hr. This position is a full-time, fully benefited work opportunity! About AtWork For You™ For over 30 years, clients and candidates have entrusted AtWork to provide workforce solutions nationwide. Our staffing and recruiting expertise in healthcare, professional, and commercial verticals have strengthened our continued relationships with clients from small businesses to Fortune 1000 organizations. Our successful relationships with top professionals in these verticals span from staff to C-Suite candidates. AtWork is honored to be the recipient of the Best in Staffing - Talent Satisfaction Award four consecutive years since 2014. We have all been on the candidate side of a career search and our philosophy is simple. Be kind, always professional, and keep communication lines open at all times. More importantly, never forget what it feels like to look for a job. Recognizing the importance of making career decisions, AtWork's team takes a simplified and personal approach when working with our candidates. Apply today and discover how we're AtWork For You™. AtWork is an Equal Opportunity Employer.
AtWork Group Tyler, TX, USA