Claims Specialist

Responsibilities

The Claims Specialist ensures that insurance and third-party claims are submitted and paid in a timely manner while maintaining compliance with regulations. They are responsible for resolving payer denials and managing pre-adjudication or follow-up tasks for facility and professional claims.

Requirements

Candidates should have experience in a healthcare revenue cycle environment and possess knowledge of medical terminology and coding. Strong attention to detail, effective communication skills, and proficiency with office software and health information systems like Epic are required.

Skills

• Claims processing
• Revenue cycle management
• Medical terminology
• Procedural coding
• Diagnostic coding
• CPT
• ICD
• Epic
• Problem resolution
• Attention to detail
• Microsoft Suite
• Communication
• Payer denials
• Workman's comp
• Commercial claims

Benefits

• Medical insurance
• Dental insurance
• Retirement program
• Time away from work
• Tuition reimbursement
• Employee assistance program
• Onsite clinic

About this role

Park Nicollet is looking to hire a Claims Specialist to join our team!  Come
join us as a Partner for Good and help us make an impact on the care and
experience that our patients and their families receive every day. 

Position Summary:

This position ensures that insurance and other 3rd party claims are submitted
and/or paid in a timely manner and are compliant with applicable regulations and
payer requirements. Specific assignments may include pre-adjudication and/or
follow-up, facility and/or professional claims, commercial and/or government
payers. Effective performance of these functions helps the organization achieve
strong cash flow and maximize patient satisfaction.

Seeking candidates with workman's comp and commercial claims experience,
particularly with resolving payer denials from the provider side. 

Required Qualifications:

Knowledge, Skills, and Abilities:

* Requires strong attention to detail and demonstrated problem resolution
skills.
* Must be able to effectively communicate verbally and via written documents.
* Moderate personal computer proficiency with word processing, spreadsheets and
email is required (preference for Microsoft Suite).
* Working knowledge of typical office equipment is expected.

Preferred Qualifications:

Education, Experience or Equivalent Combination:

* Experience in a health care revenue cycle environment preferred.

Knowledge, Skills, and Abilities:

* Ability to acquire and retain complex knowledge of department/company
processes, government policy/regulation, and payer requirements.
* Prior medical terminology and procedural/diagnostic coding (CPT, ICD)
knowledge will be helpful.
* Proficiency with Health Information Systems (e.g., Epic) preferred.

Benefits:

Park Nicollet offers a competitive benefits package (for eligible positions)
that includes medical insurance, dental insurance, a retirement program, time
away from work, insurance options, tuition reimbursement, an employee assistance
program, onsite clinic and much more! 

At HealthPartners we believe in the power of good – good deeds and good people
working together. As part of our team, you’ll find an inclusive environment that
encourages new ways of thinking, celebrates differences, and recognizes hard
work.

We’re a nonprofit, integrated health care organization, providing health
insurance in six states and high-quality care at more than 90 locations,
including hospitals and clinics in Minnesota and Wisconsin. We bring together
research and education through HealthPartners Institute, training medical
professionals across the region and conducting innovative research that improve
lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working
together to increase diversity and inclusion in our workplace, advance health
equity in care and coverage, and partner with the community as advocates for
change.

Benefits Designed to Support Your Total Health
As a HealthPartners colleague, we’re committed to nurturing your diverse
talents, valuing your dedication, and supporting your work-life balance. We
offer a comprehensive range of benefits to support every aspect of your life,
including health, time off, retirement planning, and continuous learning
opportunities. Our goal is to help you thrive physically, mentally, emotionally,
and financially, so you can continue delivering exceptional care.

Join us in our mission to improve the health and well-being of our patients,
members, and communities.

We are an Equal Opportunity Employer and do not discriminate against any
employee or applicant because of race, color, sex, age, national origin,
religion, sexual orientation, gender identify, status as a veteran and basis of
disability or any other federal, state or local protected class.

About Amery Hospital & Clinic

Hospitals and Health Care · 201-500 employees · headquartered in Amery, WI · founded 1956