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TruHearing · 1 day ago

Insurance Specialist II

Draper, UT

Full-time

Onsite

Entry, Mid Level

1+ years exp

TruHearing is a mission-based organization dedicated to improving lives through hearing healthcare solutions. The Insurance Specialist II role involves coordinating patient claims and insurance benefits for hearing aid purchases, ensuring accurate documentation and communication with health plans.

Health CareMedicalMedical Device

Comp. & Benefits

Responsibilities

Confirm patient’s insurance coverage, demographic information and other details with health plans via outbound phone calls, web chats, or online portals

Accurately document patient hearing aid benefit details, and patient information in TruHearing’s proprietary data system according to compliance requirements and TruHearing standards

Demonstrate an understanding of applicable patient claims and insurance benefits by providing specific insurance information to claimants, health plans, and members of the TruHearing insurance department

Validate patient demographic information with health plan payers (e.g., Medicare, Medicaid, private, and commercial) via outbound phone calls, web chats, or online portals

Confirm insurance claim payments are paid correctly

Apply insurance payments to patient accounts through TruHearing’s proprietary data system

Prepare basic insurance claims by transferring data from TruHearing’s proprietary data system to the clearinghouse so payers receive timely and accurate claims

Confirm that payments received from TruHearing’s Accounting Department are processed and accounts are reconciled

Complete a log of submitted claims and track to ensure timely payment from health plan partners

Qualification

Medical Claim submissionMedical Prior authorizationMedical benefit verificationManaged Care experienceFee for Service ClaimsKnowledge in AvailityKnowledge in TriZettoKnowledge in WaystarUsing TechnologyResilienceAccountabilityQualityProductivityCustomer FocusTeamworkInitiative

Required

High School Diploma or equivalent

One (1+) years' experience working in the healthcare industry, preferably directly with insurance companies

Medical Claim submission experience

Medical Prior authorization experience

Medical benefit verification experience

Preferred

Two (2+) years' experience working in the healthcare industry, preferably directly with insurance companies OR one (1+) years' experience working as a Level I Insurance Specialist at TruHearing

Managed Care experience

Fee for Service Claims experience

Knowledge in Availity, TriZetto, Waystar, other clearinghouses