Insurance Claims Specialist Careers at WVU Medicine - Remote | Apply Now!
WVU Medicine
Insurance Claims Specialist Careers at WVU Medicine - Remote | Apply Now!
Job Description
Insurance Claims Specialist at WVU Medicine - Remote Opportunity
Role Overview
WVU Medicine is seeking a dedicated and detail-oriented Insurance Claims Specialist to join our remote team. In this role, you will be responsible for managing patient account balances, ensuring accurate claim submission, and complying with all federal, state, and third-party billing regulations. Your expertise in timely follow-up and denial management will be crucial to the financial viability of WVU Medicine hospitals. You will leverage excellent customer service and communication skills to resolve customer inquiries and support the department's goals, contributing to best-in-class revenue cycle operations.
Day in the Life
As an Insurance Claims Specialist, your day will involve a variety of tasks centered around efficient and accurate claims processing. Here’s a glimpse into your daily routine:
- Claim Submission: Submitting clean claims to various insurance payers, ensuring all necessary information is included.
- Error Resolution: Identifying and resolving claim edits and account errors before submission to minimize rejections.
- Follow-Up: Diligently following up on outstanding claims within established timelines to ensure timely payment.
- Payer Communication: Contacting insurance companies via phone, email, or payer portals to resolve claim issues and gather information.
- Denial Management: Investigating and resolving claim denials by gathering supporting documentation and resubmitting corrected claims.
- Reporting: Preparing and analyzing reports on claim status, denial trends, and collection efforts.
- Customer Service: Addressing patient inquiries regarding billing statements and resolving discrepancies.
- Compliance: Adhering to HIPAA regulations and maintaining patient confidentiality.
- Account Reconciliation: Reconciling billing transactions to ensure accuracy and completeness.
- Continuous Learning: Participating in training and educational programs to stay updated on billing regulations and best practices.
Why Remote?
This remote position offers the flexibility to work from the comfort of your home while contributing to a leading healthcare system. WVU Medicine values work-life balance and provides the tools and support necessary for remote employees to thrive. Enjoy the benefits of a flexible schedule, reduced commute time, and a comfortable work environment, all while making a meaningful impact on patient care.
Career Path
WVU Medicine is committed to employee growth and development. The Insurance Claims Specialist role can serve as a stepping stone to various career opportunities within the revenue cycle department. Potential career paths include:
- Senior Claims Specialist: Taking on more complex claim resolution tasks and mentoring junior team members.
- Denial Management Specialist: Focusing on analyzing and resolving claim denials to improve revenue recovery.
- Billing Supervisor: Overseeing a team of claims specialists and ensuring efficient claims processing.
- Revenue Cycle Analyst: Analyzing revenue cycle data to identify trends and opportunities for improvement.
- Compliance Officer: Ensuring adherence to billing regulations and internal policies.
WVU Medicine also offers various training programs and educational opportunities to help employees advance their skills and knowledge.
Salary & Benefits
The estimated salary range for the Insurance Claims Specialist position is $35,000 to $55,000 per year, depending on experience and qualifications. WVU Medicine offers a comprehensive benefits package, including:
- Health Insurance: Medical, dental, and vision coverage.
- Paid Time Off: Vacation, sick leave, and holidays.
- Retirement Plan: 401(k) with employer matching contributions.
- Life Insurance: Basic and supplemental life insurance options.
- Disability Coverage: Short-term and long-term disability benefits.
- Flexible Spending Accounts: FSA and HSA options for healthcare and dependent care expenses.
- Employee Assistance Program: Confidential counseling and support services.
- Tuition Reimbursement: Assistance for continuing education and professional development.
- Employee Discounts: Discounts on WVU Medicine services and products.
- Wellness Programs: Programs to promote employee health and well-being.
WVU Medicine Culture
WVU Medicine is a leading healthcare system committed to providing high-quality patient care, research, and education. Our mission is to improve the health and well-being of the communities we serve. We foster a culture of teamwork, collaboration, and continuous improvement. Employees are valued for their contributions and are provided with opportunities to grow and develop their careers. WVU Medicine is an equal opportunity employer and is committed to diversity and inclusion.
How to Apply
To apply for the Insurance Claims Specialist position, please click the "Apply" button at the top of this page and complete the online application. Be sure to include your resume and cover letter, highlighting your relevant experience and qualifications. We look forward to reviewing your application!
Frequently Asked Questions (FAQ)
- What are the minimum qualifications for this position?
A high school diploma or equivalent is required. One year of medical billing/medical office experience is preferred. - Is this a fully remote position?
Yes, this position is fully remote, allowing you to work from home. - What software systems will I be using?
You will be using various billing software systems, payer portals, and Microsoft Office applications. - What are the key responsibilities of an Insurance Claims Specialist?
Key responsibilities include claim submission, error resolution, follow-up, denial management, and customer service. - What opportunities for professional development are available?
WVU Medicine offers various training programs, educational opportunities, and career advancement paths. - What is the work environment like at WVU Medicine?
WVU Medicine fosters a culture of teamwork, collaboration, and continuous improvement. - What benefits are offered to employees?
WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plan, and more. - How does WVU Medicine support remote employees?
WVU Medicine provides the tools, technology, and support necessary for remote employees to succeed. - What is the typical career path for an Insurance Claims Specialist?
Potential career paths include Senior Claims Specialist, Denial Management Specialist, Billing Supervisor, and Revenue Cycle Analyst. - How do I apply for this position?
Click the "Apply" button at the top of this page and complete the online application.
Locations
- Remote, West Virginia, United States (Remote)
Salary
38,500 - 60,500 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Medical Billingintermediate
- Claim Submissionintermediate
- Denial Managementintermediate
- Third Party Billingintermediate
- Revenue Cycle Operationsintermediate
- Customer Serviceintermediate
- Oral Communicationintermediate
- Written Communicationintermediate
- HIPAA Complianceintermediate
- Data Entryintermediate
- Reportingintermediate
- Account Reconciliationintermediate
- Problem Solvingintermediate
- Time Managementintermediate
- Payer Portalsintermediate
- Payer Websitesintermediate
- Analytical Skillsintermediate
- Attention to Detailintermediate
Required Qualifications
- High School diploma or equivalent required (experience)
- Preferred one (1) year of medical billing/medical office experience (experience)
- Knowledge of federal, state, and local regulations pertaining to hospital billing (experience)
- Understanding of third-party payer requirements (experience)
- Familiarity with medical terminology and coding (experience)
- Ability to accurately interpret and apply billing guidelines (experience)
- Proficiency in using computer systems and billing software (experience)
- Excellent customer service skills (experience)
- Strong written and verbal communication skills (experience)
- Ability to work independently and as part of a team (experience)
- Strong organizational and time management skills (experience)
- Ability to maintain confidentiality of patient information (experience)
Responsibilities
- Submit accurate and timely claims to third-party payers
- Resolve claim edits and account errors prior to claim submission
- Follow up with third-party payers to ensure collections and exceed department goals
- Gather statistics, complete reports, and perform other duties as scheduled or requested
- Organize and execute daily tasks to achieve optimal productivity, accountability, and efficiency
- Comply with Notices of Privacy Practices and follow all HIPAA regulations
- Contact third-party payers to resolve unpaid claims
- Utilize payer portals and payer websites to verify claim status and conduct account follow-up
- Assist Patient Access and Care Management with denials investigation and resolution
- Participate in educational programs to meet mandatory requirements and identified needs
- Attend department meetings, teleconferences, and webcasts as necessary
- Research and process mail returns and claims rejected by the payer
- Reconcile billing account transactions to ensure accurate account information
- Process billing and follow-up transactions accurately and timely
- Monitor accounts to facilitate timely follow-up and payment
- Maintain work queue volumes and productivity within established guidelines
- Provide excellent customer service to patients, visitors, and employees
- Participate in performance improvement initiatives as requested
- Work with supervisor and manager to develop and exceed annual goals
- Maintain confidentiality when interacting with patients, physicians, families, co-workers, and the public
- Communicate problems hindering workflow to management in a timely manner
Benefits
- general: Comprehensive health insurance (medical, dental, vision)
- general: Paid time off (PTO) for vacation, sick leave, and holidays
- general: Retirement plan with employer matching contributions
- general: Life insurance and disability coverage
- general: Flexible spending accounts (FSA) or health savings accounts (HSA)
- general: Employee assistance program (EAP) for confidential counseling and support
- general: Tuition reimbursement or assistance for continuing education
- general: Professional development opportunities
- general: Employee discounts on WVU Medicine services and products
- general: Wellness programs and initiatives
- general: Commuter benefits (if applicable)
- general: Employee recognition programs
- general: Opportunities for advancement within WVU Medicine
- general: A supportive and collaborative work environment
- general: Remote work flexibility
Tags & Categories
Answer 10 quick questions to check your fit for Insurance Claims Specialist Careers at WVU Medicine - Remote | Apply Now! @ WVU Medicine.
Related Books and Jobs
Insurance Claims Specialist Careers at WVU Medicine - Remote | Apply Now!
WVU Medicine
Insurance Claims Specialist Careers at WVU Medicine - Remote | Apply Now!
Job Description
Insurance Claims Specialist at WVU Medicine - Remote Opportunity
Role Overview
WVU Medicine is seeking a dedicated and detail-oriented Insurance Claims Specialist to join our remote team. In this role, you will be responsible for managing patient account balances, ensuring accurate claim submission, and complying with all federal, state, and third-party billing regulations. Your expertise in timely follow-up and denial management will be crucial to the financial viability of WVU Medicine hospitals. You will leverage excellent customer service and communication skills to resolve customer inquiries and support the department's goals, contributing to best-in-class revenue cycle operations.
Day in the Life
As an Insurance Claims Specialist, your day will involve a variety of tasks centered around efficient and accurate claims processing. Here’s a glimpse into your daily routine:
- Claim Submission: Submitting clean claims to various insurance payers, ensuring all necessary information is included.
- Error Resolution: Identifying and resolving claim edits and account errors before submission to minimize rejections.
- Follow-Up: Diligently following up on outstanding claims within established timelines to ensure timely payment.
- Payer Communication: Contacting insurance companies via phone, email, or payer portals to resolve claim issues and gather information.
- Denial Management: Investigating and resolving claim denials by gathering supporting documentation and resubmitting corrected claims.
- Reporting: Preparing and analyzing reports on claim status, denial trends, and collection efforts.
- Customer Service: Addressing patient inquiries regarding billing statements and resolving discrepancies.
- Compliance: Adhering to HIPAA regulations and maintaining patient confidentiality.
- Account Reconciliation: Reconciling billing transactions to ensure accuracy and completeness.
- Continuous Learning: Participating in training and educational programs to stay updated on billing regulations and best practices.
Why Remote?
This remote position offers the flexibility to work from the comfort of your home while contributing to a leading healthcare system. WVU Medicine values work-life balance and provides the tools and support necessary for remote employees to thrive. Enjoy the benefits of a flexible schedule, reduced commute time, and a comfortable work environment, all while making a meaningful impact on patient care.
Career Path
WVU Medicine is committed to employee growth and development. The Insurance Claims Specialist role can serve as a stepping stone to various career opportunities within the revenue cycle department. Potential career paths include:
- Senior Claims Specialist: Taking on more complex claim resolution tasks and mentoring junior team members.
- Denial Management Specialist: Focusing on analyzing and resolving claim denials to improve revenue recovery.
- Billing Supervisor: Overseeing a team of claims specialists and ensuring efficient claims processing.
- Revenue Cycle Analyst: Analyzing revenue cycle data to identify trends and opportunities for improvement.
- Compliance Officer: Ensuring adherence to billing regulations and internal policies.
WVU Medicine also offers various training programs and educational opportunities to help employees advance their skills and knowledge.
Salary & Benefits
The estimated salary range for the Insurance Claims Specialist position is $35,000 to $55,000 per year, depending on experience and qualifications. WVU Medicine offers a comprehensive benefits package, including:
- Health Insurance: Medical, dental, and vision coverage.
- Paid Time Off: Vacation, sick leave, and holidays.
- Retirement Plan: 401(k) with employer matching contributions.
- Life Insurance: Basic and supplemental life insurance options.
- Disability Coverage: Short-term and long-term disability benefits.
- Flexible Spending Accounts: FSA and HSA options for healthcare and dependent care expenses.
- Employee Assistance Program: Confidential counseling and support services.
- Tuition Reimbursement: Assistance for continuing education and professional development.
- Employee Discounts: Discounts on WVU Medicine services and products.
- Wellness Programs: Programs to promote employee health and well-being.
WVU Medicine Culture
WVU Medicine is a leading healthcare system committed to providing high-quality patient care, research, and education. Our mission is to improve the health and well-being of the communities we serve. We foster a culture of teamwork, collaboration, and continuous improvement. Employees are valued for their contributions and are provided with opportunities to grow and develop their careers. WVU Medicine is an equal opportunity employer and is committed to diversity and inclusion.
How to Apply
To apply for the Insurance Claims Specialist position, please click the "Apply" button at the top of this page and complete the online application. Be sure to include your resume and cover letter, highlighting your relevant experience and qualifications. We look forward to reviewing your application!
Frequently Asked Questions (FAQ)
- What are the minimum qualifications for this position?
A high school diploma or equivalent is required. One year of medical billing/medical office experience is preferred. - Is this a fully remote position?
Yes, this position is fully remote, allowing you to work from home. - What software systems will I be using?
You will be using various billing software systems, payer portals, and Microsoft Office applications. - What are the key responsibilities of an Insurance Claims Specialist?
Key responsibilities include claim submission, error resolution, follow-up, denial management, and customer service. - What opportunities for professional development are available?
WVU Medicine offers various training programs, educational opportunities, and career advancement paths. - What is the work environment like at WVU Medicine?
WVU Medicine fosters a culture of teamwork, collaboration, and continuous improvement. - What benefits are offered to employees?
WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plan, and more. - How does WVU Medicine support remote employees?
WVU Medicine provides the tools, technology, and support necessary for remote employees to succeed. - What is the typical career path for an Insurance Claims Specialist?
Potential career paths include Senior Claims Specialist, Denial Management Specialist, Billing Supervisor, and Revenue Cycle Analyst. - How do I apply for this position?
Click the "Apply" button at the top of this page and complete the online application.
Locations
- Remote, West Virginia, United States (Remote)
Salary
38,500 - 60,500 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Medical Billingintermediate
- Claim Submissionintermediate
- Denial Managementintermediate
- Third Party Billingintermediate
- Revenue Cycle Operationsintermediate
- Customer Serviceintermediate
- Oral Communicationintermediate
- Written Communicationintermediate
- HIPAA Complianceintermediate
- Data Entryintermediate
- Reportingintermediate
- Account Reconciliationintermediate
- Problem Solvingintermediate
- Time Managementintermediate
- Payer Portalsintermediate
- Payer Websitesintermediate
- Analytical Skillsintermediate
- Attention to Detailintermediate
Required Qualifications
- High School diploma or equivalent required (experience)
- Preferred one (1) year of medical billing/medical office experience (experience)
- Knowledge of federal, state, and local regulations pertaining to hospital billing (experience)
- Understanding of third-party payer requirements (experience)
- Familiarity with medical terminology and coding (experience)
- Ability to accurately interpret and apply billing guidelines (experience)
- Proficiency in using computer systems and billing software (experience)
- Excellent customer service skills (experience)
- Strong written and verbal communication skills (experience)
- Ability to work independently and as part of a team (experience)
- Strong organizational and time management skills (experience)
- Ability to maintain confidentiality of patient information (experience)
Responsibilities
- Submit accurate and timely claims to third-party payers
- Resolve claim edits and account errors prior to claim submission
- Follow up with third-party payers to ensure collections and exceed department goals
- Gather statistics, complete reports, and perform other duties as scheduled or requested
- Organize and execute daily tasks to achieve optimal productivity, accountability, and efficiency
- Comply with Notices of Privacy Practices and follow all HIPAA regulations
- Contact third-party payers to resolve unpaid claims
- Utilize payer portals and payer websites to verify claim status and conduct account follow-up
- Assist Patient Access and Care Management with denials investigation and resolution
- Participate in educational programs to meet mandatory requirements and identified needs
- Attend department meetings, teleconferences, and webcasts as necessary
- Research and process mail returns and claims rejected by the payer
- Reconcile billing account transactions to ensure accurate account information
- Process billing and follow-up transactions accurately and timely
- Monitor accounts to facilitate timely follow-up and payment
- Maintain work queue volumes and productivity within established guidelines
- Provide excellent customer service to patients, visitors, and employees
- Participate in performance improvement initiatives as requested
- Work with supervisor and manager to develop and exceed annual goals
- Maintain confidentiality when interacting with patients, physicians, families, co-workers, and the public
- Communicate problems hindering workflow to management in a timely manner
Benefits
- general: Comprehensive health insurance (medical, dental, vision)
- general: Paid time off (PTO) for vacation, sick leave, and holidays
- general: Retirement plan with employer matching contributions
- general: Life insurance and disability coverage
- general: Flexible spending accounts (FSA) or health savings accounts (HSA)
- general: Employee assistance program (EAP) for confidential counseling and support
- general: Tuition reimbursement or assistance for continuing education
- general: Professional development opportunities
- general: Employee discounts on WVU Medicine services and products
- general: Wellness programs and initiatives
- general: Commuter benefits (if applicable)
- general: Employee recognition programs
- general: Opportunities for advancement within WVU Medicine
- general: A supportive and collaborative work environment
- general: Remote work flexibility
Tags & Categories
Answer 10 quick questions to check your fit for Insurance Claims Specialist Careers at WVU Medicine - Remote | Apply Now! @ WVU Medicine.
Related Books and Jobs