Non-Emergency Medical Transportation Claims Specialist

Claims Specialist

Position Summary

The Claims Specialist is responsible for the timely, accurate, and compliant processing of transportation claims while serving as the primary liaison between Medi Trans, contracted transportation providers, mileage reimbursement members, and internal departments regarding claims and billing inquiries. This position ensures claims are submitted in accordance with Louisiana Medicaid, Managed Care Organization (MCO), and company requirements while providing exceptional customer service and resolving billing-related issues efficiently.

The Claims Specialist plays a key role in maintaining accurate financial records, supporting provider education, identifying claim discrepancies, and contributing to the overall integrity and efficiency of the claims process.

Compensation

Pay Type: Non-Exempt / Hourly

Benefits: Eligible for company-sponsored benefits in accordance with company policy.

Essential Functions

Claims Administration

• Review, process, and reconcile transportation claims for accuracy, completeness, and compliance with company and payer requirements.
• Educate transportation providers on proper claims submission procedures and billing requirements.
• Research, investigate, and resolve claim discrepancies, denials, payment issues, and billing inquiries.
• Ensure claims are processed accurately and within established departmental timelines.
• Monitor outstanding claims and follow up as necessary to ensure timely resolution.

Provider Support

• Serve as the primary point of contact for transportation providers and mileage reimbursement members regarding claims-related questions.
• Conduct New Provider Orientation for the Claims Department, educating providers on billing processes, documentation requirements, and claim submission guidelines.
• Maintain positive working relationships with providers while delivering exceptional customer service.

Communication & Customer Service

• Respond to emails and internal requests within established service-level expectations.
• Communicate professionally with providers, health plans, internal departments, and leadership regarding claims issues.
• Collaborate with Revenue Cycle, Credentialing, Finance, Provider Relations, Dispatch, and Compliance departments to resolve claims-related matters.

Administrative Responsibilities

• Time stamp, scan, index, and process incoming claims-related mail and documentation.
• Maintain accurate electronic records and supporting documentation.
• Prepare reports and assist with claims reconciliation as requested.
• Maintain confidentiality of all Protected Health Information (PHI) in accordance with HIPAA regulations.
• Assist with departmental audits and quality assurance initiatives.
• Perform other duties as assigned.

Minimum Qualifications

Education

Required:

• Associate's degree in Accounting, Finance, Business Administration (Accounting or Finance concentration), Healthcare Administration, or a closely related field.

Preferred:

• Bachelor's degree in Accounting, Finance, Business Administration, Healthcare Administration, or a related discipline.

Experience

• Minimum one (2) year of experience in healthcare claims processing, medical billing, accounting, finance, revenue cycle, or a related field preferred.
• Experience with Medicaid, Managed Care Organizations (MCOs), Non-Emergency Medical Transportation (NEMT), or healthcare reimbursement is highly preferred.
• Experience conducting provider training or customer service is a plus.

Knowledge, Skills & Abilities

• Strong knowledge of claims processing principles and billing practices.
• Excellent analytical and problem-solving skills.
• Ability to identify discrepancies and resolve complex billing issues.
• Strong mathematical aptitude and attention to financial accuracy.
• Excellent written and verbal communication skills.
• Exceptional customer service and interpersonal skills.
• Ability to maintain confidentiality and handle sensitive information.
• Strong organizational and time management skills.
• Ability to prioritize multiple assignments while meeting deadlines.
• Ability to work independently and collaboratively within a team environment.

Technical Skills

• Proficient in Microsoft Office Suite, particularly Excel and Outlook.
• Strong data entry and 10-key skills.
• Ability to accurately type a minimum of 35 words per minute.
• Ability to quickly learn claims management, billing, and healthcare software systems.
• Experience with electronic claims processing systems preferred.

Physical Requirements

The physical demands described are representative of those required to successfully perform the essential functions of this position. Reasonable accommodations may be made for qualified individuals with disabilities.

• Frequent sitting while performing computer-based work.
• Frequent use of hands for keyboarding and office equipment.
• Frequent verbal communication in person and by telephone.
• Occasional standing, walking, bending, and reaching.
• Ability to occasionally lift and carry up to 25 pounds.
• Ability to maintain close visual attention to detailed documents and computer screens.

Work Environment

• Primarily performed in a professional office environment.
• Moderate office noise level.
• Regular use of computers, telephones, scanners, and other office equipment.
• Standard work schedule is Monday through Friday, with additional hours as business needs require.

Core Competencies

• Attention to Detail
• Financial Accuracy
• Accountability
• Customer Service Excellence
• Critical Thinking
• Problem Solving
• Communication
• Professionalism
• Teamwork
• Adaptability
• Time Management
• Integrity & Confidentiality

Medi Trans, LLC is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other protected status under applicable law.

Pay: $22.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) 3% Match
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Experience:

• Claims: 2 years (Required)

Work Location: In person

Salary : $22 - $25