Greater Nashua Mental Health is looking for a full-time Health Claims Specialist to join our team! The Health Claims Specialist is responsible for all facets of insurance receivables of patient accounts. This position can be fully remote and the work schedule is Monday – Friday from 8:00am – 5:00pm with 1-hour for lunch.

Duties & Responsibilities: 

• Follow-up of filed claims with insurers to ensure timely collection/acknowledgment of claims.
• Routinely works accounts receivables to recover unpaid account balances.
• Processes insurance payments, patient payments, and account adjustments when applicable, including reviewing and resolving edits created by internal billing system and electronic transfer.
• Research and resolve all rejections, denials, and claims monitoring items within clearinghouse platform.
• Process claims corrections, appeals, and secondary claim submissions following insurers requirements.
• Establishes and maintains effective working relationships with insurers provider representatives.
• Monitors and reconciles MCO claim activity; filing disputes and/or communicate issues with appropriate representative of managed care organization.
• Identification, tracking, and documentation of rejection, denial, and underpayment trends.
• Effective communication with patients and others to resolve account balance issues.
• Ensures detailed documentation to patient account regarding financial status and collections effort.
• Monitors payer websites for changes related to revenue cycle processes, including but not limited to, medical policies, claims submission procedures, authorization requirements, and distributes information to applicable personnel. 
• Keeps current with industry knowledge, including but not limited to healthcare payers, changing requirements, e.g. authorizations, billing, and reimbursement; sources and attends training sessions as needed to maintain knowledge.
• Maintains access to all insurance payer portals necessary to research eligibility, claims status, and claims payment.
• Mail sorting and cash receipts reconciliation in collaboration with accounting department.
• Scanning and distribution of all mail received for Revenue Cycle Department to appropriate parties.
• Masters all system computer functions applicable to duties and maintains proficiency.
• Provides guidance and assistance to coworkers in their absence or during peak times.
• Adheres to patient privacy policies and procedures, maintaining confidentiality at all times.
• Performs other duties or special projects as required or as assigned.

Qualifications: 

•  High School Diploma or GED equivalent
• 1-2 years of related work experience
• Strong aptitude for math and accounting
• Knowledge of medical terminology and understanding of NH Medicaid benefits programs
• Basic knowledge of medical coding, billing rules, insurance reimbursement methods, and claims appeal process
• Strong collaborating skills, and an ability to work effectively both independently and as part of a team
• Comfortable in a fast-paced environment with frequent deadlines; high energy, self-motivated and proactive
• Can organize and prioritize tasks to accomplish work
• Knowledge of Microsoft Office products (Outlook, Word, Excel, Access, and PowerPoint)

Why Join Us:
We are looking for collaborative, curious for knowledge people with a “can do” mentality to join our team of compassionate employees! We provide a stimulating work environment and offer competitive salaries and comprehensive benefits including:
 

• Choice of 2 health insurance plans
• Health Reimbursement Arrangement
• Health Plan Opt Out Benefit
• Health Savings Account
• Flexible Spending Account
• Dental Insurance
• Vision Insurance
• Group Life and AD&D Insurance
• Short and Long Term Disability
• Accident & Critical Illness Insurances
• 403b Retirement Plan with Agency Match
• Employee Assistance Plan
• Generous Earned Time Off
• Paid Extended Sick Time
• 10 Paid Holidays
• Bereavement Leave
• Tuition Reimbursement
• Supervision towards Clinical Licensure
• Qualifying Employer for the Public Service Loan Forgiveness Program and NH State Loan Repayment Program

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.