Claims Specialist
Envision HealthcareThe Specialist Claims provides support for the claims and insurance teams through appropriate
reporting of medical malpractice and non-medical malpractice events as well as risk management
notifications. The Claims Intake Specialist operates under the supervision of the Senior Director of
Claims and is an integral part of the Insurance and Claims Team. This individual will communicate
with and support our providers at all levels of the claims process.
Company Overview: Envision Healthcare is a leading national medical group focused on delivering high-quality care to patients when and where they need it most. You’ll find clinicians and clinical support professionals across the nation who are proud to call Envision home. We welcome teammates of every background and work in communities that reflect the racial, ethnic, gender, sexual orientation, and economic diversity of our country.
Benefits: At Envision Healthcare, we offer benefits at the speed of your life. Our wide range of health and welfare benefits allow you to choose the right ones for you and your family. Best of all, qualifying employees are eligible to enroll from day one, so you can rest easy knowing you and your loved ones are protected. Envision Healthcare offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. The benefits offered include but not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs.
Paid Time Off: Envision Healthcare offers paid time off, 9 observed holidays and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.
Responsibilities
- Organizes the Claims Management inbox, including incoming calls, mail, and faxes; identify, prioritize, and route requests to appropriate teams.
- Coordinate and distribute claims and risk notifications to internal and external stakeholders in a timely manner.
- Verifies provider insurance coverage and credentials using multiple databases and systems.
- Prepares, reviews, and maintains claims reporting and assignment documentation in accordance with established guidelines.
- Maintains accurate internal and external claims files, ensuring documentation is complete, compliant, and up to date.
- Performs monthly reviews of submitted claims to ensure accuracy and completeness.
- Assists with insurance coverage verifications and invoice-related check requests.
- Supports data collection and reporting efforts related to claims mitigation goals and departmental metrics.
- Establishes, maintains, and updates files, databases, records, reports, SOPs, templates, and documentation libraries.
- Collaborates with internal teams and external vendors to support claims operations.
- Escalates complex, sensitive, or non-routine issues promptly to appropriate stakeholders.
- Other duties as assigned.
Qualifications
To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.
- Well-developed written and communication skills, ability to establish relationships and communicate with providers, leadership and carriers in a professional manner.
- Proficiency in Microsoft Office Suite
- Ability to recognize and define problems, collect data, establish facts, draw valid conclusions and correct errors • Strong organizational habits and follow through.
Education/Experience
- High School Degree or GED required.
- Minimum 1 year of previous work experience is required.
- Property and Casualty Claims or Insurance experience preferred
- Clinical, healthcare, claims and/or legal experience preferred
- Origami Risk Information System experience preferred
If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! We offer a highly competitive salary and a comprehensive benefits package.
Envision Healthcare uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify.
Envision Healthcare is an Equal Opportunity Employer.