Claims Specialist jobs in United States
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WRS Group · 5 hours ago

Claims Specialist

WRS Group is a medical cost containment company specializing in worker’s compensation claims. They are seeking a full-time Claims Specialist to manage customer support, facilitate resolution of claims, and maintain vendor relationships while ensuring quality service delivery.

HospitalManufacturingMedicalMedical DevicePharmaceutical

Responsibilities

Serve as primary contact for inbound and outbound customer support by phone, email, or instant message
Facilitate resolution of open receivables by review of coding, product, contract, payment agreement, fee schedule and/or authorization terms
Work independently and as part of a team on invoice renegotiations, vendor management, and provider and patient relations
Review EOB’s and address denial and partial payment of invoices in a timely and accurate manner
Maintain accurate documentation of workers compensation claim files in multiple databases
Ensure quality components of service delivery and patient/payor satisfaction with services provided
Establish and maintain strong vendor relationships
Participate in process for continuous credentialing and quality monitoring of assigned accounts
Work with team to conduct cost analysis and identify margin opportunities
Demonstrate performance aligned with WRS guiding principles, including caring, collaboration, trustparency, and innovation

Qualification

Medical claims processingCustomer supportAnalytical skillsMS Suite proficiencyVendor managementWorkers compensation knowledgeCommunicationProblem-solving abilities

Required

High School Diploma (or equivalent); college degree preferred
A customer focused approach to tasks and responsibilities
Must be analytical and solution-oriented with excellent problem-solving abilities, superior follow-up skills, and the ability to shift gears frequently throughout the day
Intermediate MS Suite, typing and email skills
Excellent verbal and written communication skills

Preferred

1+ year experience in a medical setting preferred
Familiarity of workers compensation state fee schedules preferred

Benefits

401(k)
Dental insurance
Health insurance
Paid time off
Parental leave
Vision insurance

Company

WRS Group

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At WRS, we believe in a smarter way to manage pain.

Funding

Current Stage
Growth Stage

Leadership Team

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Allan Bruford
Chief Technology Officer
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Kevin Odle
Managing Partner
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Company data provided by crunchbase