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SafeRide Health · 1 day ago

Claims Processing Specialist

San Antonio, TX

Full-time

Onsite

Entry Level

1+ years exp

SafeRide Health is a high growth, tech-enabled services firm focused on transforming access to care for the sick, poor, and underserved. They are seeking a Claims Processing Specialist to enhance their billing function and manage claims related to Medicare and Medicaid programs.

Health CareMedicalTransportation

Growth Opportunities

Responsibilities

Facilitates data processing and processes claims for NEMT and GMR rides

Performs reconciliation of billing data to encounter data. Works closely with the operations team to resolve issues

Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations

Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines

Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner

Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules

Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team

Served as the Billing team’s subject matter expert and primary contact for claims related projects and critical activities

Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues

Implement: Scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas)

Champion and reinforce SafeRide’s culture