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Claims Specialist-remote

Advanced Hearing Providers

This is a Full-time position in Spokane, WA posted November 24, 2021.

Advanced Hearing Providers (AHP) is a Demant company that brings old-fashioned customer service and hearing expertise to the workers’ compensation space.

AHP coordinates workers’ compensation hearing claims on behalf of several types of clients, including organizations such as insurance carriers, TPAs and companies that fulfill durable medical product orders.

We are seeking a motivated and experienced Claims Specialist to join our team and play a crucial and integral role in how our clients, providers, and claimants/patients receive their appropriate hearing healthcare within the workers’ compensation space.

You would be responsible for coordinating the services associated with hearing claims between clients, providers, and claimants/patients.

The types of skills that generally equate to success in this role are: self-motivation, extreme attention to detail, an ability to adapt to change, an able to manage time efficiently, and having a “can-do attitude” in a fast-paced environment.

Most important is an attitude to always strive to deliver second-to-none service throughout the process.

Responsibilities:

Maintain the respect and confidence of others, including clients, providers, claimants/patients, and colleagues, by exhibiting proper conduct, punctual attendance, dependability, and a positive attitude.

Provide customer service by phone and email in a prompt, courteous, and efficient manner.

Anticipate critical workload trends and time manages around those peak-times efficiently, without falling behind.

Embody AHP’s core values which are: create trust, have a “can-do” attitude, be a team player, and create innovative solutions.

Handle multiple tasks simultaneously in a confident and proficient manner, while performing the following duties as necessary, including, but not limited to:

Claims Specialist skills
Demonstrate an understanding of AHP’s role within the workers’ compensation claim process
Maintains contact with clients, providers, and claimants/patients on a regular basis to ensure all parties are kept apprised of the efforts being made
Works collaboratively with colleagues as needed
Adhere to Service Level Agreements (SLA’s) outlined for each client
Maintain a very high degree of detail in all aspects of coordination
Tactful in the handling and sharing of client, provider, claimant/patient information by using discretion situationally
Prioritize day according to task-driven system, always striving for completion daily with no overdue tasks
Helpful Industry-Specific Knowledge
Demonstrates an understanding of the workers’ compensation referral and RFA process
Demonstrates an understanding of navigating client/claimant requirements to ensure billable item eligibility is reviewed prior to submitting requests to client
Performs verification of all HCPC/CPT codes that will be requested.

This includes not only verifying eligibility but confirming whether NCCI edits and/or a state fee schedule (SFS), is applicable
Qualifications:
High school diploma or equivalent required
Excellent grammar and written skills required
Ability to type at a minimum of 40 WPM required
Advanced skill with appropriate computer systems and business software programs (such as Word, Excel, Outlook, Office 365 Apps and Adobe Acrobat) required
Previous workers’ compensation, insurance claims management, and/or hearing healthcare industry experience is preferred
Previous experience using Salesforce is a plus
Bilingual skills are a plus
Overnight travel may occasionally be required for training and annual meetings at a minimum.

PCCs must have the capacity to arrange for reimbursable business travel within a budget
Residence in the Portland, Oregon metro area is preferred
The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

Advanced Hearing Providers is part of the Demant Group.

Demant is a world-leading hearing healthcare group that for more than a century has played a vital part in developing innovative technologies and know-how to help improve people’s hearing and health.

In every aspect, from hearing devices, hearing implants and diagnostic equipment to intelligent audio solutions and hearing care all over the world, Demant is active and engaged.

The Demant Group operates in a global market with companies in more than 30 countries, employs more than 14,500 staff and generates annual revenue of DKK 14 billion (approx.

2.1 billion USD).

Our products are sold in more than 130 countries.

Job Type: Full-time

Pay: From $16.00 per hour

Benefits:
401(k) matching
Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance
Schedule:
8 hour shift
Monday to Friday
Supplemental Pay:
Commission pay
Work Location: Multiple Locations

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