Healthcare Claims Specialist

Location : Remote. Office is headquartered in Alameda, California. Compensation : $25.14 - $38.22 per hour ($52,300-$79,500.

per year) Residence : Candidates must reside in AZ, FL, GA, IL, LA, MA, MN, OH, OR, PA, SC, TX, or WA to be eligible for employment.

What We Do : Boost Healthcare is focused on helping healthcare providers identify and recover revenue. Our service lines include Zero Balance, AR Solutions, and Financial & Strategic Advisory.

Our team works with hospitals and physician groups to improve overall revenue by recovering denied and underpaid claims from both commercial and government payers.

We provide clients with claims data showing payer performance and root cause analysis of denial and underpayment issues.

We assess their overall business performance so they can focus on the patient experience and quality of care and let us reduce administrative burden and help drive their bottom line.

Our services are contingency based with no upfront costs to our clients. Position Summary : As a Healthcare Claims Specialist, you will work closely with your team on assigned project(s) to be a trusted point of contact between leadership and team members.

The Healthcare Claims Specialist will support the success of the Zero Balance department by evaluating and reviewing contracts between hospitals and insurance carriers and researching trends and why underpayments are occurring.

The ideal candidate for this position will have a demonstrated interest in healthcare and a desire to strengthen their analytical, team, leadership, and client relations skills.

Primary Duties and Responsibilities :

• Review contracts between hospitals and insurance carriers, model claims data, and identify lost revenue
• Contact responsible party for claim payment
• Prepare and forward claim appeal letters with supporting documentation for denial overturn
• Establish working relationships with individuals at insurance companies
• Communicate with teammates and leadership to discuss and identify trends
• Contact insurance companies via phone, email, and written appeal to recover dollars
• Perform analysis on large data sets to identify underpayment and denial trends
• Conduct research on current laws and regulations pertaining to hospital reimbursement methodology
• Contribute to client decks and weekly reports to track progress of project goals and present to leadership
• Strive to maintain a personal hourly rate by meeting project metrics and goals efficiently
• Attend Privacy and Security Training as required by the HIPAA Awareness Program and comply with all guidelines,policies and procedures to assure sensitive or confidential information is protected in accordance with the HIPAArules and regulations
• Other duties as assigned Required Qualifications :
• Detail-oriented and organized with the ability to manage time effectively and prioritize competing tasks
• Excellent communication skills both written and verbal
• Effective documentation skills
• Strong organizational skills
• Possesses analytical capabilities and financial acumen
• Must have private and dedicated workspace that ensures confidentiality
• Base internet download speed of 10 MBPS and upload of 35 MBPS Nice-to-Have Qualifications :
• Undergraduate degree or internship in a healthcare related field
• Understanding of health insurance, EHR’s, EMR’s, and claims handling
• Healthcare operations experience
• Understanding of auditing and reporting tools such as SQL
• Presentation skills and client relations experience a plus Who We Are : Boost Healthcare is a remote team of 70+ employees and growing with a nationwide clientele base lead by Liana Hamilton, founder and managing partner.

Our core values are being Trustworthy, Dedicated, Valued, Resourceful and Fun. We prioritize hard work and collaboration among our teams, our clients, and the communities we serve.

We place high importance on connection, including face-to-face daily interactions, and make sure to carve out time for play.

We hope you join our team and grow with us. Culture The culture at Boost Healthcare embraces a passion for continual process improvements, collaboration and building trusted long-lasting partnerships within our team and partners.

We believe that every voice matters, needs to be heard and we value all perspectives as inclusiveness is key to our success.

Maintaining a strong workplace culture is a top priority for us so if you want to focus on people first, join our team. Benefits Boost Healthcare provides a competitive benefits package including medical, dental, vision, and 401k benefits as well as a flexible schedule and stipends that cover education and technology.

Boost is an Equal Opportunity Employer. Offers of employment are contingent on successful completion of background check. Powered by JazzHR