Medical Claims Retrieval Specialist

Job Title: Medical Claims Retrieval Specialist (Remote)

Our team mission is to support patients and elevate healthcare through diligent and accurate medical record retrieval. As the vital link between healthcare providers, insurers, and Cotiviti, we take pride in our role as trusted facilitators, enabling seamless collaboration and communication. We are steadfast in our commitment to excellence, driven by a passion for making a tangible impact on the lives of patients and the broader healthcare community. Together, we strive to create a world where high-quality care is accessible and attainable for all.

We are seeking a highly motivated and experienced Medical Claims Retrieval Specialist to join our remote team. The ideal candidate should have excellent communication skills, be able to work independently, and possess a background in healthcare or insurance-related industries. In addition, the candidate should be metrics-focused, able to use assertive language to progress objectives, demonstrate strong critical thinking skills, and have a mindset of self-improvement and continuous growth.

Responsibilities:

• Make outbound calls to medical providers and insurance companies to retrieve medical records and facilitate the claims retrieval process.
• Utilize available resources to solve issues on the phone and reach out for help resolving claims when needed.
• Request medical records on behalf of insurance companies for review and overcharge collection afterward.
• Update database with claim information and ensure accuracy of data.
• Meet daily/weekly/monthly call targets as set by management.
• Actively seek feedback and apply it to improve performance and achieve objectives.
• Continuously strive for self-improvement and professional growth.

Requirements:

• At least 1 year of experience in an outbound call center in a healthcare, insurance, or collections environment.
• Strong communication skills, both written and verbal.
• Ability to work independently and in a team environment.
• Excellent organizational skills with the ability to multitask.
• Proficient in Microsoft Office.
• Knowledge of medical terminology and the insurance industry is highly preferred.
• Must have a high-speed internet connection that is hardwired to the router.
• Maintain a HIPAA-compliant environment, which includes an environment free of distractions, free of others being able to view/hear business activities, and in a secured area.
• Metrics-focused mindset, with the ability to use assertive language to progress objectives and leverage strong critical thinking skills.
• Openness to feedback and a commitment to continuous improvement and growth.

We also have created a list of certain things our recruiters can be on the lookout for as criteria for the job.

Recruiting Criteria:

• Prior experience in healthcare, insurance, or collections industries.
• Demonstrated ability to work in fast-paced, remote environments with minimal supervision.
• Strong communication skills, including the ability to communicate professionally and effectively with medical providers and insurance representatives.
• Knowledge of medical terminology and the insurance industry.
• Proven track record of meeting or exceeding call targets and deadlines.
• Familiarity with Microsoft Office.
• Candidates with additional relevant certifications or training in medical billing, coding, or insurance will be given preference.
• Ability to maintain a HIPAA-compliant work environment, ensuring privacy and security.
• Metrics-focused mindset, with a commitment to continuous improvement and growth.
• Highlight our team mission: Our team mission is to support patients and elevate healthcare through diligent and accurate medical record retrieval. As the vital link between healthcare providers, insurers, and Cotiviti, we take pride in our role as trusted facilitators, enabling seamless collaboration and communication. We are steadfast in our commitment to excellence, driven by a passion for making a tangible impact on the lives of patients and the broader healthcare community. Together, we strive to create a world where high-quality care is accessible and attainable for all.