What are the responsibilities and job description for the Claims Status Specialist (GF) position at TVG-Medulla, LLC?
General Description
TVG-Medulla, LLC provides support and services to two comprehensive chiropractic care companies, Chiro One Wellness Centers and MyoCore Personalized Pain Care, both industry leaders in evidence-based, patient outcomes-centered care.
The Claims Status Specialist will maximize insurance collections by investigating claim status on assigned accounts and performing appropriate follow up actions to ensure payment of claims.
Essential Functions And Responsibilities
All team members agree to consistently support compliance and TVG-Medulla, LLC policies and Standards of Excellence with regard to maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, adhering to applicable federal, state, and local laws and regulations, accreditation, and licenser requirements (if applicable), and Medulla procedures and protocols. Must perform other related duties and assist with project completion as needed. Team member may be required to provide necessary information to complete a DMV (or equivalent agency) background check.
TVG-Medulla, LLC provides support and services to two comprehensive chiropractic care companies, Chiro One Wellness Centers and MyoCore Personalized Pain Care, both industry leaders in evidence-based, patient outcomes-centered care.
The Claims Status Specialist will maximize insurance collections by investigating claim status on assigned accounts and performing appropriate follow up actions to ensure payment of claims.
Essential Functions And Responsibilities
- Investigate status of insurance claims on assigned accounts by reviewing mail/EOBs, insurance websites, calling insurance companies, etc.
- Facilitate collections of balances due by performing the appropriate follow up actions once claim status is determined.
- Review claims submissions for errors and update/correct erroneous claims.
- Maintain patient ledgers on assigned accounts to reflect accurate balances due.
- Communicate with clinical teams regarding information requests and claim status updates and maintain follow up as needed.
- Maintain claim status log with detail of status and actions taken on assigned accounts.
- Ensure all communication is clear, professional, and branded.
- Notify management of any strange scenarios, possible compliance concerns or recurring issues.
- Proficient computer and data entry skills
- Excellent written and verbal communication
- Basic knowledge of insurance benefits
- Familiarity in Microsoft Office (primarily Outlook, Excel, and Word)
- Two or more years of insurance, billing, or related experience
- Ability to remain calm and professional during difficult situations
- Excellent written and verbal communication skills
- Ability to multi-task and prioritize
- Solution-oriented approach to problem-solving
All team members agree to consistently support compliance and TVG-Medulla, LLC policies and Standards of Excellence with regard to maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, adhering to applicable federal, state, and local laws and regulations, accreditation, and licenser requirements (if applicable), and Medulla procedures and protocols. Must perform other related duties and assist with project completion as needed. Team member may be required to provide necessary information to complete a DMV (or equivalent agency) background check.
