Medical Claims Specialist

Compensation: $22.00 - $25.00 per hour depending on experience 

Location: Blue Ash, OH

In-Office Full-Time, Monday-Friday

Benefits Summary

• Medical, dental, vision, and 401K
• Supplemental insurance available
• Matching 401k (up to 6% match)
• Paid Time Off (PTO)

SUMMARY

On behalf of CNS Cares, LLC (“CNS” or “Company”), this position is responsible for developing relationships with leads and claimants, associated retiree groups, physicians, authorized representatives, agency personnel, and other various stakeholders associated with the EEOICPA program and other programs as required.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Employee must have regular attendance/punctuality, have excellent customer service skills, be able to work with others at all levels of the Company and be completely honest. This position will be in office, without remote capability. Other assigned duties include:

1. Provide assistance to claimants as needed, by guiding claimants through the claim filing process, and supporting in other ways as needed.
2. Determine what benefits these individuals may qualify for under the EEOICPA or other identified programs.
3. Assist in research and gather work history and medical records as necessary.
4. Help claimants file initial claims and refile claims that have been denied.
5. Inform individuals of the resources available that may assist their claim process and overall health and wellness.
6. Answering & returning frequent phone calls/emails in a polite & timely manner with internal and external customers.
7. Maintains industry knowledge by participating in educational and training opportunities.
8. Assists in identifying efficiencies and improving processes.
9. Maintains contact with professionals of various health service agencies, after obtaining a Release of Information, to determine Claimant eligibility services.
10. Occasionally will attend outreach events as needed.
11. Other duties as assigned.

RELATED COMPETENCIES

Knowledge of DOL EEOICPA program, knowledge of the EEOICPA application process, specifically the records necessary for any potential claimant to file a claim under the EEOICPA. Knowledge of medical terminology and the ability to translate terminology into verbal and written communication.

Must be able to read, analyze, and interpret general business practices, policies and procedures, professional journals, technical guidelines, and governmental regulations. Must be able to write reports, business correspondence, and procedure manuals. Must be able to effectively present information and respond to questions from groups of managers, clients, customers, and the public. 

Must be able to use, at an intermediate level, Microsoft Office Suite (Word, Excel, etc.). Ability to read, interpret and extract information from agency materials, both electronic and in hard copy.

Identify opportunities and take action to build strategic relationships between one's area and other areas, teams, departments, units, or organizations to help achieve business goals.

Identify and understand issues, problems, and opportunities; have the ability to compare data from different sources to draw conclusions; utilize effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.

EDUCATION and/or EXPERIENCE

Required:

• High school Diploma or GED; 
• Two (2) years of related program or clinical/medical experience and/or training. 

Preferred: 

Certified Medical Assistant (CMA) certification, Licensed Practical Nurse (LPN), or at least one (1) year of specific DOL EEOICPA program experience.

CERTIFICATES, LICENSES, REGISTRATIONS, & MEDICAL REQUIREMENTS

Driver’s License

LPN or CMA, preferred.

#TFIND