Claims Specialist I (Full-time)

Claims Specialist I (Full‑time) Shift: Day | Employment Status: Full‑Time (.75 or greater) | Hours per Pay Period: 1.00 = 80 hours every two weeks (Non‑Exempt) | Starting Wage DOE: $17.00–$21.25 The Claims Specialist’s main focus is to obtain maximum and appropriate reimbursement for all claims from government and third‑party payers. The position requires preparing and submitting timely and accurate insurance claims, ensuring compliance with payer regulations, and verifying payments and adjustments are appropriately applied to accounts. Essential Job Functions Submit timely and accurate claims to primary, secondary, and tertiary insurances for both electronic and paper submission. Generate telephone calls to insurance carriers to follow up on insurance using reports to ensure timely collection of money due. Audit accounts by verifying reimbursement amounts, coordinating refunds, adjustments, appeals, or resubmissions, and resolving credit balances. Ensure claims contain correct information for submission and review payer‑specific regulations and requirements. Prepare and present verbal and written challenges to third‑party payers for additional reimbursement for denied charges. Provide guidance or assistance to cashiers and respond to inquiries regarding coverage issues, coordination of benefits, and account balance reconciliation. Set up registration and insurance information when necessary. Utilize performance improvement principles to assess and improve quality. Identify needs, set goals for personal growth, and maintain competency in safety standards. Perform other duties as assigned to meet departmental needs. Minimum Qualifications One year of previous office experience. Patient accounts or insurance billing experience preferred. Education Not specified; an equivalent combination of education and experience will be considered. Experience Refer to qualifications above. EEO Statement Billings Clinic is committed to being an inclusive and welcoming employer that strives to be kind, safe, and courageous in all we do. As an equal‑opportunity employer, our policies and processes are designed to achieve fair and equitable treatment of all employees and job applicants. All employees and job applicants will be provided the same treatment in all aspects of the employment relationship, regardless of race, color, religion, sex, gender identity, sexual orientation, pregnancy, marital status, national origin, age, genetic information, military status, and/or disability. To ensure we provide an accessible candidate experience for prospective employees, please let us know if you need any accommodations during the recruitment process. #J-18808-Ljbffr