Claims Specialist

Innova Solutions is immediately hiring for a Claims Specialist

Position type : Contract

Duration : 6 months

Location : Must be located in Denver metro area* The first day of orientation is onsite and there may be some aspects of training that may need to be done in person until candidate gets up to speed.

As a(n) Claim Specialistyou will :

Under the direction of the Compliance and Contracts Manager, the Claims Specialist is responsible for working with insurance companies to perform denial resolution on outstanding claims and supports the internal Credentialing process of the center.

A successful candidate for the Claims Specialist position can utilize their previous medical billing experience to collaborate and communicate effectively with stakeholders while demonstrating problem-solving skills, bringing denied claims to resolution and working to submit necessary credentialing applications to enroll providers in Medicare, Medicaid and Commercial payer insurance.

Essential Functions

Billing :

Work closely with billing staff to review denied claims related to provider credentialing.

Interacts with payers to determine true reason for denial and inquire on what corrections need to be made.

Collaborates with internal and external stakeholders to ensure necessary corrections are submitted timely and accurately.

Ability to work and update multiple issues within a ticketing queue, providing regular status updates.

Sees through the claims reprocessing to achieve the desired results.

Credentialing :

Completes credentialing and re-credentialing applications to add providers to Medicare, Medicaid and Commercial Payers.

Completes revalidation requests issued by government payers.

Maintains accurate and up to date provider profiles on CAQH, PECOS, NPPES, and CMS databases.

Maintains internal documentation to ensure all information is accurate.

Support Credentialing staff in completing quarterly attestations for payers.

Qualifications :

High School or GED required, Associates or Bachelor’s preferred.

2+ years health care and medical billing / Revenue Cycle experience required.

General knowledge of finance and accounting functions, policies, practices and terminology.

Ability to research and problem solve, using analytical and critical thinking skills.

Ability to handle multiple tasks simultaneously and work autonomously.

Demonstrated history of resolving challenging issues.

Strong interpersonal skills, including excellent written and verbal communication skills.

Familiarity with Microsoft Office suite (Excel, Outlook, Word) and strong computer skills.

Thank you!

Anil Sharma

Sr. Associates

PAY RANGE AND BENEFITS :

Pay Range* : $25 - $28 / hr

Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits : Innova Solutions offers benefits( based on eligibility) that include the following : Medical & pharmacy coverage, Dental / vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).