Medical Claims Specialist at CNSCares

Idaho Falls, Idaho, United States -

Full Time

Start Date

Immediate

Expiry Date

25 Feb, 26

Salary

24.0

Posted On

27 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Medical Terminology, Claims Processing, Research, Communication, Teamwork, Punctuality, Honesty, Efficiency Improvement, Health Services Knowledge, EEOICPA Knowledge, Claim Filing, Record Gathering, Outreach Events, Problem Solving, Training Participation

Industry

Hospitals and Health Care

Description

Description Pay Rate: $20.00 - $24.00 per hour depending on experience, plus bonus potential Location: Idaho Falls, ID Full-Time, In-Office, Monday-Friday Benefits Summary Medical, dental, vision, and 401K Health Savings Account (HSA) Matching 401k 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: Provide assistance to claimants as needed, by guiding claimants through the claim filing process, and supporting in other ways as needed. Determine what benefits these individuals may qualify for under the EEOICPA or other identified programs. Assist in research and gather work history and medical records as necessary. Help claimants file initial claims and refile claims that have been denied. Inform individuals of the resources available that may assist their claim process and overall health and wellness. Answering & returning frequent phone calls/emails in a polite & timely manner with internal and external customers. Maintains industry knowledge by participating in educational and training opportunities. Assists in identifying efficiencies and improving processes. Maintains contact with professionals of various health service agencies, after obtaining a Release of Information, to determine Claimant eligibility services. Occasionally will attend outreach events as needed. Other duties as assigned. Requirements EDUCATION and/or EXPERIENCE Required: High school Diploma or GED Two 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. 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. CERTIFICATES, LICENSES, REGISTRATIONS, & MEDICAL REQUIREMENTS Driver’s License LPN or CMA, preferred not required The following background checks are conducted: Criminal Background Driving Record OIG Exclusion List Sex Offender Registry #TFIND

Responsibilities

The Medical Claims Specialist is responsible for developing relationships with claimants and assisting them through the claim filing process. This includes guiding claimants, determining benefits eligibility, and maintaining contact with health service agencies.