Claims Specialist I
$39,312–$43,680 year
RemoteUnited States
Job Summary
Coordinate authorized hearing healthcare for covered employees by obtaining a thorough understanding of workers' compensation claims administration, fees, and participants. Maintain contact with clients, providers, and claimants to ensure all parties are informed of process status while adhering to customer Service Level Agreements. Prioritize daily tasks using our task-based systems to achieve completion of all required work, ensuring orders are properly documented and verified for billable item eligibility. Perform verification of HCPC/CPT codes, confirm applicability of NCCI edits and state fee schedules, and coordinate necessary documentation for state agencies. Assist with phone answering and intake duties, utilizing phone, email, and fax for efficient communication. This role supports AHP's mission to connect patients with qualified hearing healthcare providers nationwide, fostering a collaborative team environment focused on trust and consistent results.
Required Qualifications
- Advanced knowledge and experience with computer systems and business software programs, in particular Salesforce, Word, Excel, Outlook, Office 365 Apps and Adobe Acrobat
- Ability to type at a minimum of 40 WPM
- Ability to travel for training and occasional on-site meetings
- Must have a high attention to detail
- Must be coachable and receptive to feedback
- Must be dependable and consistent
- Ability to take a proactive approach to all situations
- Driven by a focus on reaching a specific objective or accomplishing a given task
- Eagerness to adapt to new methods
- Obtain satisfaction from delivering great customer service
- Willing to try new things/operate outside of your comfort zone
- Communicate clearly, professionally and in a timely manner
- Manage multiple tasks simultaneously in a proficient manner
- Ability to maintain professional client and provider relationships
- Work collaboratively with colleagues, including regularly providing direct support by completing team members' tasks for them as needed
- Understand when situational discretion must be employed in the handling and sharing of client, provider, and/or claimant information
- Self-motivated; ability to work independently
Desired Qualifications
- Previous workers' compensation, insurance claims management, and/or hearing healthcare industry experience is preferred
- Bilingual skills will be extremely helpful with some patients
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