TriCore Reference Laboratories · 10 hours ago
Claims Specialist-Journal Center, (783)
Albuquerque, NM
Full-time
Onsite
Entry Level
1+ years expTriCore Reference Laboratories is seeking a Claims Specialist to manage accounts receivables on patient accounts and contracted insurances. The role involves following up on claims, analyzing reports, and maintaining communication with insurance representatives.
Health CareMedicalTest and Measurement
Responsibilities
Collects outstanding accounts receivables on patient accounts from patient, commercial, non-government, contracted insurances or government payors via phone call to the patient or insurance company or by means of written appeal or reconsideration
Pursues collection activities on assigned accounts from primary and secondary payors until worked to resolution to include claims resubmission, appeal or reconsideration
Works account receivables reports (i.e. aged-trial-balance report), focusing attention on accounts over 60 days
Researches adjustments and pull all necessary backup to support adjustments
Utilizes on-line insurance resources to obtain and maintain current information
Develops and maintains a professional working rapport with internal and external customers to include contacts with insurance company representatives
Identifies trends in payment or non-payment of claims. Communicates findings to leadership and co-workers as appropriate
Customizes reports in Antrim and or Excel to prioritize accounts for collecting
Qualification
Required
High school diploma or equivalent
Must have one of the following: Six (6) months as an Apprentice in the Business Office at TriCore, Minimum of one (1) year of laboratory or medical claims follow-up/collections experience, Minimum of three (3) years of medical billing or claims processing experience
Must be able to type 30 words per minute (typing test required)
Must have basic PC knowledge and working expertise with keyboard, mouse, Internet, and Windows based applications
Proficient in PC/data entry skills
Must be able to work independently with little direction and to demonstrate sound judgment and problem solving skills
Ability to resolve problems and follow up as needed or appropriate
Effective communication skills and telephone skills
Ability to deal with difficult clients and patients
Strong working knowledge of insurance and reimbursement
Preferred
Basic knowledge of Excel and Word
Knowledge of medical terminology
Company
TriCore Reference Laboratories
TriCore Reference Laboratories is a clinical information company that offers laboratory research and testing facility for health management.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Robin Divine
President & CEO
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