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Birdsong Hearing Benefits · 18 hours ago

Claims Specialist I

United States

Full-time

Hybrid

New Grad, Entry Level

$18.90/hr - $22.05/hr

Birdsong Hearing Benefits coordinates hearing healthcare services for employees with workers’ compensation claims. The Claims Specialist I plays a critical role in ensuring authorized hearing healthcare for injured workers while maintaining communication with clients, providers, and patients.

Health CareMedicalMedical DeviceWellness

Responsibilities

Obtain a complete, thorough understanding of the workers’ compensation claims administration process, fees and participants

Adhere to customer Service Level Agreements (SLAs) by maintaining contact with clients, providers, and claimants/patients as prescribed to ensure all parties are kept informed of the process status

Successfully prioritize the workday utilizing our task-based systems, resulting in achieving daily completion of all required tasks (ensuring SLA compliance)

Ensure orders are properly documented in a timely manner

Demonstrate an understanding of the workers’ compensation referral and RFA process

Demonstrate an understanding of navigating client/claimant requirements to ensure billable item eligibility is reviewed prior to submitting requests to client

Perform verification of all HCPC/CPT codes that will be requested. This includes not only verifying eligibility but confirming whether NCCI edits and/or a state fee schedule (SFS), is applicable

Coordinate the completion of necessary documentation to be filed with state agencies when applicable

Maintain a high degree of detail and accuracy throughout the claim administration process

Cross utilize phone, email, and fax for communication to ensure efficient processing time

Assist with phone answering and intake related duties

Demonstrate basic to intermediate level process understanding and ability to critically think and solution for complex situations that arise

Other duties as assigned by the manager

Qualification

SalesforceWorkers' compensation experienceExcelOutlookAdobe AcrobatBilingual skillsGrammarTyping 40 WPMCustomer serviceAttention to detail

Required

HS Diploma or equivalent

Advanced knowledge and experience with computer systems and business software programs, in particular Salesforce, Word, Excel, Outlook, Office 365 Apps and Adobe Acrobat

Excellent grammar and written skills

Ability to type at a minimum of 40 WPM

Ability to travel for training and occasional on-site meetings

Communicate clearly, professionally and in a timely manner

Manage multiple tasks simultaneously in a proficient manner

Ability to maintain professional client and provider relationships

Work collaboratively with colleagues, including regularly providing direct support by completing team members' tasks for them as needed

Understand when situational discretion must be employed in the handling and sharing of client, provider, and/or claimant information

Self-motivated; ability to work independently

Must have a high attention to detail

Must be coachable and receptive to feedback

Must be dependable and consistent