What are the responsibilities and job description for the Claims Processing Specialist position at SafeRide Health?
SafeRide Health is looking for a hands-on Claims Specialist to scale SafeRide. We are looking for a leader with deep experience managing Medicare and Medicaid programs as we scale past $100M in annual revenue. The Billing Specialist is responsible for elevating SafeRide’s billing function and continuously enhancing the effectiveness of the organization. Strong business and financial orientation as well as a passion for growth and development are critical for this role.
Responsibilities
Responsibilities
- Facilitates data processing and processes claims for NEMT and GMR rides.
- Performs reconciliation of billing data to encounter data. Works closely with the operations team to resolve issues.
- Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations.
- Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines.
- Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner.
- Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules.
- Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team.
- Served as the Billing team’s subject matter expert and primary contact for claims related projects and critical activities.
- Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues.
- Implement: Scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas).
- Champion and reinforce SafeRide’s culture.
- Minimum 1 years of experience in billing/claims management
- Must be bilingual Spanish Speaking
- NEMT/transportation background preferred
- Knowledge of CMS/HHSC regulations preferred
- Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc.
- Self-starter, ability to work independently and in a team environment.
- Strength in problem solving, applying hard data and qualitative insight to frame problems and develop novel solutions
- Ability to adapt to unforeseen circumstances quickly
- Keen attention to detail
- Ability to work with a variety of stakeholders
- An inclusive, encouraging and collaborative company culture
- Strong support for career growth, including access to our investor communities
- Competitive compensation with upside for growth (including stock options and performance grants)
- Competitive benefits including health/vision/dental insurance, 401k match and 18 day’s PTO
Salary : $100