Birdsong Hearing Benefits coordinates hearing healthcare services for employees with workers’ compensation claims. The Claims Specialist I plays a critical role in ensuring authorized hearing healthcare for injured workers while maintaining communication with clients, providers, and patients.
Responsibilities
- Obtain a complete, thorough understanding of the workers’ compensation claims administration process, fees and participants
- Adhere to customer Service Level Agreements (SLAs) by maintaining contact with clients, providers, and claimants/patients as prescribed to ensure all parties are kept informed of the process status
- Successfully prioritize the workday utilizing our task-based systems, resulting in achieving daily completion of all required tasks (ensuring SLA compliance)
- Ensure orders are properly documented in a timely manner
- Demonstrate an understanding of the workers’ compensation referral and RFA process
- Demonstrate an understanding of navigating client/claimant requirements to ensure billable item eligibility is reviewed prior to submitting requests to client
- Perform verification of all HCPC/CPT codes that will be requested. This includes not only verifying eligibility but confirming whether NCCI edits and/or a state fee schedule (SFS), is applicable
- Coordinate the completion of necessary documentation to be filed with state agencies when applicable
- Maintain a high degree of detail and accuracy throughout the claim administration process
- Cross utilize phone, email, and fax for communication to ensure efficient processing time
- Assist with phone answering and intake related duties
- Demonstrate basic to intermediate level process understanding and ability to critically think and solution for complex situations that arise
- Other duties as assigned by the manager
Skills
- HS Diploma or equivalent
- Advanced knowledge and experience with computer systems and business software programs, in particular Salesforce, Word, Excel, Outlook, Office 365 Apps and Adobe Acrobat
- Excellent grammar and written skills
- Ability to type at a minimum of 40 WPM
- Ability to travel for training and occasional on-site meetings
- Communicate clearly, professionally and in a timely manner
- Manage multiple tasks simultaneously in a proficient manner
- Ability to maintain professional client and provider relationships
- Work collaboratively with colleagues, including regularly providing direct support by completing team members' tasks for them as needed
- Understand when situational discretion must be employed in the handling and sharing of client, provider, and/or claimant information
- Self-motivated; ability to work independently
- Must have a high attention to detail
- Must be coachable and receptive to feedback
- Must be dependable and consistent
- Ability to take a proactive approach to all situations
- Driven by a focus on reaching a specific objective or accomplishing a given task
- Eagerness to adapt to new methods
- Obtain satisfaction from delivering great customer service
- Willing to try new things/operate outside of your comfort zone
- Previous workers' compensation, insurance claims management, and/or hearing healthcare industry experience is preferred
- Bilingual skills will be extremely helpful with some patients
Benefits
- Medical, dental, prescription, and vision benefits
- 24/7 virtual medical care
- Employee Assistance Program for you and your family
- 401(k) with company match
- Company-paid life insurance
- Supplemental insurance for yourself, your spouse/partner, and your children
- Short-term and long-term disability insurance
- Pre-tax Health Savings Account and Flexible Spending Accounts for Health Care or Dependent Care
- Pet Insurance
- Commuter accounts
Company Overview
Birdsong Hearing Benefits is a healthcare service providing hearing health services. It was founded in 2022, and is headquartered in Jacksonville, Florida, USA, with a workforce of 11-50 employees. Its website is https://birdsonghearing.com.
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