Insurance Claims Specialist - Remote

Overview

The Insurance Claims Specialist is responsible for managing patient account balances, ensuring accurate claim submission, compliance with regulations, and assisting with denial management to support the financial viability of WVU Medicine hospitals.

In Short

• Manage patient account balances and claim submissions.
• Ensure compliance with billing regulations.
• Provide excellent customer service and resolve inquiries.
• Complete reports and clerical duties as needed.
• Contact third-party payers to resolve unpaid claims.
• Participate in educational programs for personal growth.
• Adhere to HIPAA regulations regarding patient information.
• Utilize payer portals for claim status verification.
• Assist with denial investigations and resolutions.
• Maintain confidentiality and effective communication.

Requirements

• High School diploma or equivalent required.
• One year of medical billing or office experience preferred.
• Excellent oral and written communication skills.
• Knowledge of medical terminology preferred.
• Understanding of ICD-10 and CPT coding processes preferred.
• Ability to work effectively in a team and independently.
• Strong organizational skills and attention to detail.
• Ability to handle confidential information responsibly.
• Proficient in using computers and relevant software.
• Ability to communicate tactfully and diplomatically.

Benefits

• Opportunity for personal and professional growth.
• Work in a supportive team environment.
• Access to educational programs and training.
• Engagement in performance improvement initiatives.
• Potential for career advancement within the health system.