Senior Complex Claims Specialist managing high - severity Professional Lines claims from inception to resolution. Collaborating with legal and underwriting teams while providing mentorship to the claims team.
About the role
- Handle day to day operations assisting staff with insurance matters
- Supervise, advise and oversee posting, collections, and/or reimbursement functions
- Counsel patients and/or families on options for financial assistance and account management
- Communicate policies and educate staff on billing issues to promote efficient flow of billing process
- Advise department managers on collection issues
- Handle missing charge ticket list, locate missing tickets and generate replacement tickets
- Work with pharmacy for appropriate drug pricing when not available in system
- Monitor and update monthly collection totals in department
- Advise affected areas on diagnoses, prices and charges for special batches
- Participate in selection, training, supervising and evaluating employees; inform employees of departmental changes
- Assist with coverage in staff areas during illness/vacations; back-up for HMO/PPO Representative
- Assist IBC team with special projects
- Primarily remote with the exception of coming into the office at least once a month
Requirements
- Associate degree or combination of education and experience may substitute for minimum education
- No specific certification required
- Relevant Experience (5 Years)
- Skills: Accounting, Communication, Customer Service, Finance, Health Insurance, Organizing, Problem Solving, Supervisory Management
- Driver's License: A driver's license is not required for this position
Benefits
- Up to 22 days of vacation
- 10 recognized holidays
- Sick time
- Competitive health insurance packages with priority appointments and lower copays/coinsurance
- Free Metro transit U-Pass for eligible employees
- Defined contribution (403(b)) Retirement Savings Plan with university contributions starting at 7%
- Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians
- 4 weeks of caregiver leave to bond with your new child
- Family care resources
- Tuition coverage for employee and family (dependent undergraduate-level tuition up to 100% at WashU and 40% elsewhere after seven years)
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HS
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