Skip to main content
Tallo logoTallo logo

Find Jobs

Find Jobs Near You – Available Work in Your Location

Skip to job details
Apply for this opportunity

To apply for this job, you'll continue to an external website or email application.

UMC Health System

Claims Management Specialist

Entry-Level JobVerifiedNo experience needed

Career Insights for Claims Adjuster / Specialist (General)

See where this job fits in the broader career landscape. Knowing your career path helps you see what's possible from here.

Scorecard

Based on Texas data

Review key factors to help you decide if this role fits your goals. How is this calculated?

Were these scores useful?

What they do

A Claims Adjuster or Specialist investigates and evaluates insurance claims. Specializes in a particular type of insurance. Inspects property damage, including damage to homes, buildings and cars; reviews claims after they are submitted; may authorize or deny payment for claims. May work directly for insurers or on behalf of claimants.

$70,991 / year median in Texas

+10% projected growth

Explore Career

Job Description

We've learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas®.
JOB SUMMARY
Must have the ability to communicate both verbally and in writing. Mainframe computer skills, basic accounting, detailed clerical skills and good customer relation skills are required. Candidate must manage accounts according to third party payer rules and regulations. Candidate must posses an understanding of medical and third party payer terminology.
REPORTS TO
JOB
SPECIFIC RESPONSIBILITIES
Process claim production queues appropriately Review claim production reports and claim production edit reports Understand payer specific requirements for electronic and paper claim submission Document accurately on visits in IDX to convey the billing issue for correction. Take corrective action when errors are noted on claims Review payer confirmation reports to ensure all transmitted claims were received by payers Review paper claims to ensure that affected claims cannot be submitted electronically Work hold bills assigned by supervisor Communicates effectively with supervisor and staff to reduce the number of recurring claim errors Audits the payer table within Click-On to ensure that claims are submitted to the correct payers
EDUCATION AND EXPERIENCE
High school graduate or equivalent required.
REQUIRED LICENSURES/CERTIFICATIONS/REGISTRATIONS
None required.
SKILLS AND ABILITIES
Highly technical. Troubleshooting skills are required.
INTERACTION WITH OTHER DEPARTMENTS AND OTHER RELATIONSHIPS
This position requires interaction with most other UMC Health System departments, medical staff, and technical personnel at Texas Tech University Health Sciences Center and Physician Network Services. This position also deals directly with technical support analysts employed by contracted hardware and software vendors.
PHYSICAL CAPABILITIES
Work is of medium demand. Walking, sitting and standing most of the time while on-duty. Occasional lifting of equipment is required. Adequate hand/eye coordination and fine motor skills required for typing. Talking and hearing is essential in dealing with co-workers and customers.
ENVIRONMENTAL/WORKING CONDITIONS
Works in a well-lighted, heated and ventilated building.
DIRECT REPORTS
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. •Request for accommodations in the hire process should be directed to UMC Human Resources.•