Insurance and Claims Specialist

Explore opportunities at The Corvallis Clinic, part of the Optum family of businesses . For more than 75 years, our multi - specialty group has been committed to delivering exceptional care to our patients and fulfilling careers to our team members. As a leading clinic in Oregon's mid - Willamette Valley, we serve more than a quarter - million people with offices in Corvallis, Albany and Philomath. Join a team that empowers you from the start and values work - life balance, teamwork and trust. We offer comprehensive benefits and competitive pay. Elevate your career with us and discover the meaning behind Caring. Connecting. Growing together.

The responsibility of the Insurance and Claims Specialist is to ensure accurate claim processing by being the primary source for creating, verifying, and updating current insurance for all Corvallis Clinic departments. This will require maintaining a current knowledge of insurance carrier rules and regulations, current coordination of benefits rules, and being a liaison between the insurance carriers and Clinic departments and patients. The Insurance and Claims Specialist will also aid in claims creation for all departments.

This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 AM - 5:00 PM. It may be necessary, given the business need, to work occasional overtime. Our office is located at 444 NW Elk Drive, Corvallis, OR.

This will be paid on-the-job training and the hours during training will be aligned with your schedule.

Primary Responsibilities:

• Will participate and maintain a culture within The Corvallis Clinic consistent with the content outlined in the Service and Behavioral Standards document; To this end, employee will be expected to read, have familiarity, and embrace the principles contained within

• Verifies insurance coverage through Athena, insurance websites, or through phone calls to the insurance company to verify eligibility, referrals and benefit information for proper patient insurance set - up and billing, for upcoming appointments

• Works through eligibility issues found in Athena for the departments throughout the Clinic each day

• Processes, completes, and resolves claim issues found in the Front Desk Claim inbox

• Maintains a current knowledge of insurance carrier rules and regulations, i. e. , referrals, co - payments, etc.

• Research complicated insurance issues in order to resolve them for clean claim creation

• Acts as a liaison with the insurance carriers, departments, and patients

• Acts as a resource for front office staff throughout the day by answering insurance questions

• Creates timely claims for all TCC (The Corvallis Clinic) departments:

• Submission of timely and accurate claims to ensure TCC is capturing the highest potential revenue for each department

• Timely and accurate claim creation will drive revenue and will assist in meeting organizational monthly goals

• Reviews, edits, and creates claims that are 'difficult' or in a 'hold status' to ensure proper billing

• Engages in continuing education and self - evaluation to remain a knowledgeable specialist; This includes attendance and participation in department meetings; and remaining current on department policies and procedures

• Participates in orientation and training of new employees; focusing on insurance basics required for MOS on the front desk

• Communicates with providers regarding outstanding encounters that need to bill out as claims

• Works as a team with the other insurance and claim specialists in order to broaden knowledge and resolves issues as efficiently as possible

• Continually trains staff on insurance claims and authorization

• Ensures the authorization, claims, and preregistration hotline is always supported and answered when front office support is need

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED OR equivalent years of experience

• Must be 18 years of age OR older

• 1+ years of experience in a medical office with knowledge of insurance and claims

• Knowledge of medical terminology and understanding of insurance carriers

• Ability to successfully pass a pre - employment insurance assessment as part of the selection process

• Basic computer skills including Microsoft Word and Microsoft Excel

• Ability to work any of our shift schedules during our normal business hours of 8:00 AM - 5:00 PM from Monday - Friday. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• 1+ years of experience in the customer service field

Soft Skills:

• Ability to work well with providers and other staff

• Ability to work on multiple tasks simultaneously in a busy, fast - paced environment while maintaining quality of work

The hourly range for this role is $16. 88 to $33. 22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other chara.