Claims Specialist

WRS Group is a medical cost containment company that specializes in managing worker's compensation claims. They are seeking a full-time Claims Specialist to serve as the primary contact for customer support, facilitate resolution of open receivables, and maintain accurate documentation of claims files.

Responsibilities

• Serve as primary contact for inbound and outbound customer support by phone, email, or instant message
• Facilitate resolution of open receivables by review of coding, product, contract, payment agreement, fee schedule and/or authorization terms
• Work independently and as part of a team on invoice renegotiations, vendor management, and provider and patient relations
• Review EOB’s and address denial and partial payment of invoices in a timely and accurate manner
• Maintain accurate documentation of workers compensation claim files in multiple databases
• Ensure quality components of service delivery and patient/payor satisfaction with services provided
• Establish and maintain strong vendor relationships
• Participate in process for continuous credentialing and quality monitoring of assigned accounts
• Work with team to conduct cost analysis and identify margin opportunities
• Demonstrate performance aligned with WRS guiding principles, including caring, collaboration, trustparency, and innovation

Skills

• High School Diploma (or equivalent); college degree preferred
• 1+ year experience in a medical setting preferred
• A customer focused approach to tasks and responsibilities
• Must be analytical and solution-oriented with excellent problem-solving abilities, superior follow-up skills, and the ability to shift gears frequently throughout the day
• Intermediate MS Suite, typing and email skills
• Excellent verbal and written communication skills
• Familiarity of workers compensation state fee schedules preferred

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Parental leave
• Vision insurance

Company Overview