Medical Claims Specialist

At the Vitrolife Group, we work every day to unlock the full potential of science and technology to reduce the barriers towards building a family. Together we help our customers and their patients to fulfill the dream of having a baby.

The Medical Claims Specialist’s primary role is to monitor and respond to all medical
claims transactions and to ensure that the company’s policies and procedures are
followed to achieve accurate and timely processing for payment. The Medical Claims Specialist is a professional resource with an incredible attitude and an honest approach to handling multiple and competing challenges and administrative responsibilities that contribute to operational performance and effectiveness.

Key Responsibilities: 

• Insurance Billing: Review, prepare, and transmit new claims.
• Ensure timely payment posting for all different insurance payers.
• Insurance verification: Confirm patient benefits and insurance as needed.
• Interact with third party representative and utilize online sites to review status and update claims as needed to expedite the claims process.
• Monitors accounts and pursues collection of past due balances with frequent collection calls.
• Analyze and inform management of any denial pattern by any insurance company.
• Answer phone lines and emails related to insurance questions/concerns.
• Excellent verbal and written communication skills and customer service skills when dealing with patient calls.
• Responds to questions, provides support, and assists in resolution of issues brought forth by team members, customers, and internal departments.
• Assists with incoming mail (electronic and hard) for invoices, credits, and various other payment adjustments to assist with payments, collection efforts, and reporting.
• Working knowledge of ICD-10, CPT coding requirements.
• Prepares spreadsheets and assists in special projects as needed or as directed by management.
• Assists with internal/external audits as needed.
• Works professionally and efficiently with all levels within the organization.
• Complies with policies, procedures, guidelines, and regulatory requirements and standards.
• Able to work in a fast-paced environment within a team.

QUALIFICATIONS

Education and Experience:

• Minimum Associate’s degree in Accounting or Business Administration preferred.

• 3+ years’ experience directly involving medical claims processing.

Knowledge, Skills, and Abilities:

• Proficiency in MS Word, PowerPoint, Outlook and Excel to include pivot tables and V-Lookups.
• Highly organized with close attention to detail with proactive follow up and accurate priority setting.
• Responsible, professional, and adaptable in a fast-growing environment.
• Organizational skills, time management and priority setting.
• Confidentiality and discretion.
• Sound judgment with ability to ask questions, provide solutions and improve processes.
• Communication and interpersonal skills.
• Self-motivated and takes ownership of their responsibilities.

Benefits:

• Paid Time Off
• 10 Paid Holidays
• 401(k) with Employer Match
• Medical/Dental/Vision/ GAP insurance
• Basic Life and AD&D
• Short / Long Term Disability
• Critical Illness and Accident Insurance
• Employee Assistance Program
• Flexible Spending & Health Savings Account

An offer of employment is contingent on the successful passing of a background check. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.

Vitrolife Group is a global provider of medical devices and genetic services. Based on science and advanced research capabilities, we develop services and products for personalised genetic information and medical device products. We support our customers by improving their clinical practice for the patient's outcome of a fertility treatment.

We are currently approximately 1 100 colleagues worldwide, with headquarters in Gothenburg, Sweden. Vitrolife Group's products and services are available in more than 110 countries through our own presence in 30 countries and a network of distributors. Vitrolife Group is a sustainable market leader and aims to be the preferred partner for IVF-clinics by providing superior products and services with the vision of fulfilling the dream of having a baby. The Vitrolife share is listed on Nasdaq Stockholm.