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Insurance Coverage Claims Resolution Specialist

Location: Charlotte, NC, United States
Job # 11042765
Date Posted: 06-11-2018
Insurance Coverage Claims Resolution Specialist – 
Charlotte, NC 28262
Pay: $18/HR 
Full Time Hours M-F
About the company-
We are a leading financial and administrative healthcare network in the United States that connects virtually all private and government payers, claim-submitting providers and pharmacies in a hybrid cloud-based, user-centric and secure infrastructure environment.

The ideal candidate will have a confident phone presence and be comfortable making 30 outbound calls a day to receive claim information with strong problem-solving skills, as every new claim can have their own unique challenges.  It is imperative for candidates to have Property and Casualty (Auto Insurance, Workers’ Compensation) experience.

  • Contact Auto/Work Comp insurance carriers and attorneys via telephone to identify available accident insurance coverage for the patient
  • Comfortable with a high volume of claims
  • You bring experience with complex billing hospital, insurance, physician claims
  • Verify patient’s eligibility for coverage and obtain billing contact information for the insurance adjuster and/or attorney
  • Initiate outbound calls to patients to complete accident interviews via telephone
  • Investigate and confirm any medical coverage related to auto, general liability, and/or worker compensation insurance available to the patient, updating the patient file in the system
  • Send hospital bill to no-fault, third party and workers’ compensation insurances via fax, mail and e-mail
  • Follow up for with insurance carriers and attorneys for expedited resolution and payment on patient’s account
  • You will be responsible for investigating, billing and collecting on hospital claims from Property & Casualty insurance carriers (ex: Auto Insurance, Work Comp). 
  • You will communicate with patients, insurance adjusters and attorneys to resolve claims.
  • Initiate outbound calls to patients to complete accident interviews via telephone
  • You have 1+ year workers comp revenue cycle experience
  • Experience with Medical Software
  • You have property and casualty (Auto Insurance, & Workers’ Compensation) experience
  • You have health insurance appeals experience
  • You have coordination of benefits experience preferred
If qualified, please respond with your resume saved as a Word document. 
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