• Claims Specialist

    Randstad ProfessionalsNashville, TN 37214

    Salary: $17 - 19 per hour

    Job #787945043

  • job summary:

    Claims Specialist - Nashville, TN

    • This is one contract role expected to last 6 months.

    Claims Specialist - Job Requirements:

    • Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement. Receives denied claims and researches appropriate appeal steps.
    • Collect required documentation, review file documentation, and make sure all items needed are requested. Ensure that all claim documentation is complete, accurate, and complies with company policy.
    • Establish, maintain, and update files, databases, records, and other documents for recurring internal reports. Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials Contact and communicate with clients by telephone, e-mail, or in-person.

    Qualifications:

    • Basic knowledge in lending and the real estate industry. Excellent written and verbal communication. Strong attention to detail.
    • Ability to handle multiple tasks with frequent interruptions. Knowledge of basic accounting processes and procedures.
    • Basic computer skills including Microsoft Office.
    • Associate?s degree in billing, coding, business, finance or related field required; equivalent work experience may be substituted for education 2 to 5 years of experience required.

    Compensation: $17-$19/hr

     

    location: Nashville, Tennessee

    job type: Contract

    salary: $17 - 19 per hour

    work hours: 9 to 5

    education: Bachelor's degree

    experience: 5 Years

     

    responsibilities:

    COB analysts are responsible for using established methods to investigate, verify, and record third party liability (TPL) coverage information on behalf of our Medicaid payer clients. COB analysts research TPL coverage leads through various methods including phone calls, correspondence, and online portals. COB Analysts maintain accurate TPL coverage to trigger appropriate cost-avoidance and recovery activities. COB analysts also respond to provider research requests and may be assigned other tasks as requested by management. COB analysts operate in a fast-paced, production environment and take ownership of their work product by understanding the value of timely, accurate TPL lead investigation.

    Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement. Receives denied claims and researches appropriate appeal steps. Collect required documentation, review file documentation, and make sure all items needed are requested. Ensure that all claim documentation is complete, accurate, and complies with company policy. Establish, maintain, and update files, databases, records, and other documents for recurring internal reports. Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials Contact and communicate with clients by telephone, e-mail, or in-person.

     

    qualifications:

    Successful candidates will possess:

    • Ability to adapt to the significant and frequent changes of the healthcare market

    • Ability to work within a team environment with a positive attitude

    • Strong investigative skills with detail orientation

    • Strong multi-tasking ability

    • Proficiency with time and workload management

    • Very strong verbal and written communication skills

    • Proficiency Microsoft Windows and Office products (esp. Word and Excel)

    • Overtime may be required based on operational need

    Job Requirements:

    • Bachelor's degree or work experience with health insurance eligibility verification

    • Background in government and/or commercial insurance healthcare coverage is a plus

    • Must successfully pass a background check

     

    skills: SAP, Excel

    Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

    Company Description:

    Randstad is a $22.5 billion global provider of HR services and the second largest staffing organization in the world. From temporary staffing to permanent placement to in-house, professionals, search & selection, and HR Solutions, Randstad holds top positions around the world and has approximately 31,100 corporate employees working from its nearly 4,700 branches and in-house locations in 40 countries.

    We are a company built on a deep network of expertise that crosses industries and geographies. We recognize that talent comes in different forms, that every business has its unique challenges and opportunities. And our recruiting experts are skilled at marrying talent and business—identifying the ideal professionals for an organization’s culture and its teams, its needs and its goals.

    Updated 12/18/2018

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