Claims Specialist
WRS Group is a medical cost containment company that specializes in managing worker's compensation claims. They are seeking a full-time Claims Specialist to serve as the primary contact for customer support, facilitate resolution of open receivables, and maintain accurate documentation of claims files.
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
Skills
- High School Diploma (or equivalent); college degree preferred
- 1+ year experience in a medical setting 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
- Familiarity of workers compensation state fee schedules preferred
Benefits
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Parental leave
- Vision insurance
Company Overview