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 - Remote Opportunity at WVU Medicine
Role Overview
Are you a detail-oriented professional with a passion for healthcare finance? WVU Medicine is seeking a dedicated 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 timely follow-up and assistance with denial management will be crucial in maintaining the financial viability of WVU Medicine hospitals.
As an Insurance Claims Specialist, you will employ excellent customer service and communication skills to provide support and resolve issues arising from customer inquiries. You will also contribute to the department's work by completing reports and clerical duties as needed, working closely with leadership and team members to achieve best-in-class revenue cycle operations.
A Day in the Life
Here's what a typical day might look like for an Insurance Claims Specialist at WVU Medicine:
- Morning: Start your day by reviewing outstanding claims and prioritizing tasks. You'll submit accurate and timely claims to various third-party payers, ensuring all necessary documentation is included.
- Mid-Day: You'll address claim edits and account errors to prevent rejections and delays. A significant portion of your time will be spent following up on unpaid claims, utilizing payer portals and websites to check claim statuses and resolve issues.
- Afternoon: You'll assist Patient Access and Care Management teams with denial investigations, working to resolve issues and resubmit claims. You'll also reconcile billing account transactions to ensure accurate account information and adherence to established procedures.
- Ongoing: Throughout the day, you'll communicate with patients, visitors, and colleagues, providing excellent customer service and maintaining confidentiality. You'll also participate in educational programs and meetings to stay updated on industry changes 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 organization. Enjoy a better work-life balance, reduced commute time, and the ability to create a personalized workspace. WVU Medicine provides the tools and support you need to succeed in a remote environment, fostering a collaborative and connected team culture.
Career Path
WVU Medicine is committed to employee growth and development. Starting as an Insurance Claims Specialist, you can advance your career through various pathways. Potential career advancements include:
- Senior Insurance Claims Specialist: Take on more complex cases and mentor junior team members.
- Denial Management Specialist: Focus on researching and resolving denied claims, becoming a subject matter expert in this area.
- Revenue Cycle Analyst: Analyze revenue cycle data to identify trends, improve processes, and maximize revenue capture.
- Team Lead or Supervisor: Oversee a team of Insurance Claims Specialists, providing guidance, training, and support.
Salary & Benefits
WVU Medicine offers a competitive salary and benefits package for Insurance Claims Specialists. The estimated salary range for this position is $35,000 to $55,000 per year, depending on experience and qualifications. In addition to salary, WVU Medicine provides a comprehensive benefits package, including:
- Comprehensive health insurance (medical, dental, vision).
- Paid time off (PTO) for vacation, sick leave, and holidays.
- Retirement plan with employer matching contributions.
- Life insurance and disability coverage.
- Flexible spending accounts (FSA) or health savings accounts (HSA).
- Employee assistance program (EAP) for confidential counseling and support.
- Tuition reimbursement or assistance for continuing education.
- Professional development opportunities and training programs.
- Employee discounts on various products and services.
- Wellness programs and initiatives to promote employee health.
- Commuter benefits or transportation assistance.
WVU Medicine Culture
WVU Medicine is a leading healthcare system in West Virginia, known for its commitment to patient care, innovation, and community service. As an employee, you'll be part of a team that values collaboration, respect, and continuous improvement. WVU Medicine fosters a supportive and inclusive work environment where employees are encouraged to grow and develop their skills.
How to Apply
If you're ready to join the WVU Medicine team as an Insurance Claims Specialist, we encourage you to apply! Simply click the "Apply" button at the top of this page and complete the application form. Be sure to highlight your relevant experience and qualifications, and tell us why you're passionate about healthcare finance.
FAQ
- What are the minimum qualifications for this position?
A high school diploma or equivalent is required. One year of medical billing or 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 and systems will I be using?
You will be using various payer portals, billing software, and Microsoft Office Suite.
- What opportunities for professional development are available?
WVU Medicine offers various training programs, tuition reimbursement, and opportunities to attend conferences and workshops.
- How does WVU Medicine support employee well-being?
WVU Medicine offers wellness programs, an employee assistance program, and various resources to promote employee health and well-being.
- What is the typical career path for an Insurance Claims Specialist?
Potential career advancements include Senior Insurance Claims Specialist, Denial Management Specialist, Revenue Cycle Analyst, and Team Lead or Supervisor.
- What is the work environment like at WVU Medicine?
WVU Medicine fosters a collaborative, supportive, and inclusive work environment where employees are valued and respected.
- What is the dress code for remote employees?
While working remotely, it is important to maintain a professional appearance, especially during video conferences. Business casual attire is recommended.
- How will I be trained for this role?
WVU Medicine provides comprehensive training, including on-the-job training, online modules, and mentorship programs.
- What are the key performance indicators (KPIs) for this role?
Key performance indicators include claim submission accuracy, timely follow-up on unpaid claims, and adherence to productivity standards.
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
- Problem Solvingintermediate
- Analytical Skillsintermediate
- Time Managementintermediate
- Prioritizationintermediate
- Microsoft Office Suiteintermediate
- Payer Portalsintermediate
- Account Reconciliationintermediate
- Regulatory Complianceintermediate
- Teamworkintermediate
- Adaptabilityintermediate
- Attention to Detailintermediate
- ICD-10 Codingintermediate
- CPT Codingintermediate
- Medical Terminologyintermediate
Required Qualifications
- High School diploma or equivalent required. (experience)
- One (1) year of medical billing or medical office experience preferred. (experience)
- Knowledge of medical billing processes and procedures. (experience)
- Understanding of third-party payer regulations and guidelines. (experience)
- Familiarity with HIPAA regulations and patient privacy practices. (experience)
- Ability to work independently and as part of a team. (experience)
- Strong attention to detail and accuracy. (experience)
- Excellent communication and interpersonal skills. (experience)
- Proficiency in using computer systems and software applications. (experience)
- Ability to prioritize tasks and manage time effectively. (experience)
- Demonstrated problem-solving skills. (experience)
- Experience with denial management and appeals processes. (experience)
- Knowledge of medical coding (ICD-10, CPT) is a plus. (experience)
- Commitment to providing excellent customer service. (experience)
- Ability to maintain confidentiality of patient information. (experience)
Responsibilities
- Submits accurate and timely claims to third-party payers.
- Resolves claim edits and account errors before claim submission.
- Adheres to appropriate procedures and timelines for follow-up with third-party payers to ensure collections.
- Gathers statistics, completes reports, and performs other duties as scheduled or requested.
- Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability, and efficiency.
- Complies with Notices of Privacy Practices and follows all HIPAA regulations pertaining to PHI and claim submission/follow-up.
- Contacts third-party payers to resolve unpaid claims.
- Utilizes payer portals and payer websites to verify claim status and conduct account follow-up.
- Assists Patient Access and Care Management with denials investigation and resolution.
- Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
- Attends department meetings, teleconferences, and webcasts as necessary.
- Researches and processes mail returns and claims rejected by the payer.
- Reconciles billing account transactions to ensure accurate account information according to established procedures.
- Processes billing and follow-up transactions in an accurate and timely manner.
- Develops and maintains working knowledge of all federal, state, and local regulations pertaining to hospital billing.
- Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts.
- Maintains work queue volumes and productivity within established guidelines.
- Provides excellent customer service to patients, visitors, and employees.
- Participates in performance improvement initiatives as requested.
- Works with supervisor and manager to develop and exceed annual goals.
- Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers, and the public regarding demographic/clinical/financial information.
- Communicates 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 and training programs.
- general: Employee discounts on various products and services.
- general: Wellness programs and initiatives to promote employee health.
- general: Commuter benefits or transportation assistance.
- general: Opportunities for career advancement within WVU Medicine.
- general: A supportive and collaborative work environment.
- general: Recognition programs for outstanding employee performance.
- general: Access to WVU Medicine facilities and services.
- general: Employee referral bonuses for successful hires.
- general: Diversity and inclusion initiatives to foster a welcoming workplace.
- general: Opportunities to participate in community outreach programs.
- general: Competitive salary and compensation packages.
- general: Remote work options for eligible positions.
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 - Remote Opportunity at WVU Medicine
Role Overview
Are you a detail-oriented professional with a passion for healthcare finance? WVU Medicine is seeking a dedicated 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 timely follow-up and assistance with denial management will be crucial in maintaining the financial viability of WVU Medicine hospitals.
As an Insurance Claims Specialist, you will employ excellent customer service and communication skills to provide support and resolve issues arising from customer inquiries. You will also contribute to the department's work by completing reports and clerical duties as needed, working closely with leadership and team members to achieve best-in-class revenue cycle operations.
A Day in the Life
Here's what a typical day might look like for an Insurance Claims Specialist at WVU Medicine:
- Morning: Start your day by reviewing outstanding claims and prioritizing tasks. You'll submit accurate and timely claims to various third-party payers, ensuring all necessary documentation is included.
- Mid-Day: You'll address claim edits and account errors to prevent rejections and delays. A significant portion of your time will be spent following up on unpaid claims, utilizing payer portals and websites to check claim statuses and resolve issues.
- Afternoon: You'll assist Patient Access and Care Management teams with denial investigations, working to resolve issues and resubmit claims. You'll also reconcile billing account transactions to ensure accurate account information and adherence to established procedures.
- Ongoing: Throughout the day, you'll communicate with patients, visitors, and colleagues, providing excellent customer service and maintaining confidentiality. You'll also participate in educational programs and meetings to stay updated on industry changes 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 organization. Enjoy a better work-life balance, reduced commute time, and the ability to create a personalized workspace. WVU Medicine provides the tools and support you need to succeed in a remote environment, fostering a collaborative and connected team culture.
Career Path
WVU Medicine is committed to employee growth and development. Starting as an Insurance Claims Specialist, you can advance your career through various pathways. Potential career advancements include:
- Senior Insurance Claims Specialist: Take on more complex cases and mentor junior team members.
- Denial Management Specialist: Focus on researching and resolving denied claims, becoming a subject matter expert in this area.
- Revenue Cycle Analyst: Analyze revenue cycle data to identify trends, improve processes, and maximize revenue capture.
- Team Lead or Supervisor: Oversee a team of Insurance Claims Specialists, providing guidance, training, and support.
Salary & Benefits
WVU Medicine offers a competitive salary and benefits package for Insurance Claims Specialists. The estimated salary range for this position is $35,000 to $55,000 per year, depending on experience and qualifications. In addition to salary, WVU Medicine provides a comprehensive benefits package, including:
- Comprehensive health insurance (medical, dental, vision).
- Paid time off (PTO) for vacation, sick leave, and holidays.
- Retirement plan with employer matching contributions.
- Life insurance and disability coverage.
- Flexible spending accounts (FSA) or health savings accounts (HSA).
- Employee assistance program (EAP) for confidential counseling and support.
- Tuition reimbursement or assistance for continuing education.
- Professional development opportunities and training programs.
- Employee discounts on various products and services.
- Wellness programs and initiatives to promote employee health.
- Commuter benefits or transportation assistance.
WVU Medicine Culture
WVU Medicine is a leading healthcare system in West Virginia, known for its commitment to patient care, innovation, and community service. As an employee, you'll be part of a team that values collaboration, respect, and continuous improvement. WVU Medicine fosters a supportive and inclusive work environment where employees are encouraged to grow and develop their skills.
How to Apply
If you're ready to join the WVU Medicine team as an Insurance Claims Specialist, we encourage you to apply! Simply click the "Apply" button at the top of this page and complete the application form. Be sure to highlight your relevant experience and qualifications, and tell us why you're passionate about healthcare finance.
FAQ
- What are the minimum qualifications for this position?
A high school diploma or equivalent is required. One year of medical billing or 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 and systems will I be using?
You will be using various payer portals, billing software, and Microsoft Office Suite.
- What opportunities for professional development are available?
WVU Medicine offers various training programs, tuition reimbursement, and opportunities to attend conferences and workshops.
- How does WVU Medicine support employee well-being?
WVU Medicine offers wellness programs, an employee assistance program, and various resources to promote employee health and well-being.
- What is the typical career path for an Insurance Claims Specialist?
Potential career advancements include Senior Insurance Claims Specialist, Denial Management Specialist, Revenue Cycle Analyst, and Team Lead or Supervisor.
- What is the work environment like at WVU Medicine?
WVU Medicine fosters a collaborative, supportive, and inclusive work environment where employees are valued and respected.
- What is the dress code for remote employees?
While working remotely, it is important to maintain a professional appearance, especially during video conferences. Business casual attire is recommended.
- How will I be trained for this role?
WVU Medicine provides comprehensive training, including on-the-job training, online modules, and mentorship programs.
- What are the key performance indicators (KPIs) for this role?
Key performance indicators include claim submission accuracy, timely follow-up on unpaid claims, and adherence to productivity standards.
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
- Problem Solvingintermediate
- Analytical Skillsintermediate
- Time Managementintermediate
- Prioritizationintermediate
- Microsoft Office Suiteintermediate
- Payer Portalsintermediate
- Account Reconciliationintermediate
- Regulatory Complianceintermediate
- Teamworkintermediate
- Adaptabilityintermediate
- Attention to Detailintermediate
- ICD-10 Codingintermediate
- CPT Codingintermediate
- Medical Terminologyintermediate
Required Qualifications
- High School diploma or equivalent required. (experience)
- One (1) year of medical billing or medical office experience preferred. (experience)
- Knowledge of medical billing processes and procedures. (experience)
- Understanding of third-party payer regulations and guidelines. (experience)
- Familiarity with HIPAA regulations and patient privacy practices. (experience)
- Ability to work independently and as part of a team. (experience)
- Strong attention to detail and accuracy. (experience)
- Excellent communication and interpersonal skills. (experience)
- Proficiency in using computer systems and software applications. (experience)
- Ability to prioritize tasks and manage time effectively. (experience)
- Demonstrated problem-solving skills. (experience)
- Experience with denial management and appeals processes. (experience)
- Knowledge of medical coding (ICD-10, CPT) is a plus. (experience)
- Commitment to providing excellent customer service. (experience)
- Ability to maintain confidentiality of patient information. (experience)
Responsibilities
- Submits accurate and timely claims to third-party payers.
- Resolves claim edits and account errors before claim submission.
- Adheres to appropriate procedures and timelines for follow-up with third-party payers to ensure collections.
- Gathers statistics, completes reports, and performs other duties as scheduled or requested.
- Organizes and executes daily tasks in appropriate priority to achieve optimal productivity, accountability, and efficiency.
- Complies with Notices of Privacy Practices and follows all HIPAA regulations pertaining to PHI and claim submission/follow-up.
- Contacts third-party payers to resolve unpaid claims.
- Utilizes payer portals and payer websites to verify claim status and conduct account follow-up.
- Assists Patient Access and Care Management with denials investigation and resolution.
- Participates in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
- Attends department meetings, teleconferences, and webcasts as necessary.
- Researches and processes mail returns and claims rejected by the payer.
- Reconciles billing account transactions to ensure accurate account information according to established procedures.
- Processes billing and follow-up transactions in an accurate and timely manner.
- Develops and maintains working knowledge of all federal, state, and local regulations pertaining to hospital billing.
- Monitors accounts to facilitate timely follow-up and payment to maximize cash receipts.
- Maintains work queue volumes and productivity within established guidelines.
- Provides excellent customer service to patients, visitors, and employees.
- Participates in performance improvement initiatives as requested.
- Works with supervisor and manager to develop and exceed annual goals.
- Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers, and the public regarding demographic/clinical/financial information.
- Communicates 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 and training programs.
- general: Employee discounts on various products and services.
- general: Wellness programs and initiatives to promote employee health.
- general: Commuter benefits or transportation assistance.
- general: Opportunities for career advancement within WVU Medicine.
- general: A supportive and collaborative work environment.
- general: Recognition programs for outstanding employee performance.
- general: Access to WVU Medicine facilities and services.
- general: Employee referral bonuses for successful hires.
- general: Diversity and inclusion initiatives to foster a welcoming workplace.
- general: Opportunities to participate in community outreach programs.
- general: Competitive salary and compensation packages.
- general: Remote work options for eligible positions.
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