Medical Claims Specialist - Team Lead

Are you ready to make a significant impact in healthcare finance? Do you have a knack for navigating the complexities of medical claims and insurance processes?

LHH is looking for a dedicated and detail-oriented Medical Claims and Collections Specialist to join our team onsite in Maui, HI

Key Responsibilities :

Train and direct subordinates, ensuring efficiency in medical claims processing.

Handle billing for non-dues revenue guaranteed by third-party payors and patients.

Perform clerical functions and basic accounting procedures, including editing and retrieving accounting data related to claims, payments, and cost logs.

Manage assigned accounts, including background information collection and arrangement of payments.

Comply with state and federal regulations and guidelines related to third-party payors.

Act as a liaison between subordinates and management, maintaining up-to-date knowledge of Kaiser Health Plan benefits and policies.

Perform medical collections and follow-up tasks, including phone calls to insurance carriers and submitting clinical documentation.

Analyze delinquent accounts to determine collectability and prepare write-off accounts for supervisor review.

Generate appropriate adjustments and validate through thorough research.

Minimum Qualifications :

One (1) year of experience in collections or medical insurance claims processing as a supervisory or lead.

Proficiency in diversified clerical functions and basic accounting procedures.

Demonstrated ability to motivate debtors to pay and to provide exceptional customer service.

Strong skills in adaptability, change management, conflict resolution, and teamwork.

Excellent oral and written communication skills in English.

Strong mathematical ability, attention to detail, and alertness.

Preferred Qualifications :

Two (2) years of collections experience in the healthcare field.

Knowledge of medical terminology, CPT-4, and ICD-9-CM coding.

Familiarity with mainframe collections applications.

Proficiency with 10-key by touch.

Experience with VR billing processes and Charge Description Master codes.

Apply Today!

If you are passionate about medical claims and collections and ready to contribute to a team that values excellence and innovation, we want to hear from you! Apply now and take the next step in your career with LHH.

Pay Details : $ to $ per hour

Search managed by : Allyson Leahy

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan.

Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs.

In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.