SHP Claims Specialist
- Continually seek to understand and act upon client needs, concerns and priorities on various types of claims including but not limited to: Health Insurance, Worker’s Compensation and Motor Vehicle Accident claims.
- Utilize various client computer systems to obtain information required to process insurance claims and document all efforts performed on behalf of the client.
- Identify the appropriate payer source and submit claims information to insurance companies according to specific payer requirements.
- Contact insurance companies to resolve claim processing issues that are delaying reimbursement.
- Contact patients to obtain insurance information.
- Review medical bills for possible CPT/HCPCS coding issues.
- Review Explanation of Benefit forms to identify underpayments and pursue underpaid line items.
- Assist SHP’s attorneys with special client projects.
- Ability to problem solve, prioritize duties and follow-through completely with assigned tasks.
- Excellent communication skills – both written and verbal.
- Above average analytical and critical thinking skills.
- Good organizational and prioritization skills.
- Intermediate understanding of medical billing form requirements (UB04 and CMS 1500).
- Intermediate understanding of ICD-9, ICD-10, CPT and HCPCS coding rules and regulations.
- Proficiency in Word and Excel.
- High School Diploma or equivalent required. Some college coursework in Health/Business administration preferred.
- 2-3 years’ medical claims and/or hospital collections experience preferred.
SHP is always looking for qualified individuals to join our team: if you are interested in joining our team, please contact our Human Resources Manager.