Claims Payables Specialist
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Job Description
Claims Payables Specialist in healthcare processing value-based care claims. Collaborating with departments to ensure compliance and efficiency in claims management.
Responsibilities:
- Process and adjudicate value-based care claims in accordance with established policies, procedures, and regulatory requirements.
- Review processed claims for accuracy, completeness, and compliance with contractual agreements and reimbursement guidelines.
- Investigate and resolve discrepancies in claim information.
- Ensure timely and accurate payment of value-based care claims.
- Maintain thorough documentation of claims processing activities.
- Collaborate with other departments to address claim-related inquiries.
- Assist in the development and implementation of process improvements.
Requirements:
- Bachelor's degree in Finance, Accounting, Healthcare Administration, or a related field
- Minimum of 2 years of experience in claims processing, preferably in value-based care or healthcare reimbursement
- Proficient in claims processing systems and EDI technology
- Available to work full-time with occasional travel for training and provider engagement activities
- Certification in healthcare billing or claims management (CPC, CPPS, or similar) is a plus
- Must complete interviews and assessments independently without external assistance.
Benefits:
- Offers Bonus
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