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Claims Payment Specialist
Career Insights for Claims Adjuster / Specialist (General)
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Based on Texas data
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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
Job Description
Claims Payment Specialist Full-Time We're looking for a detail-oriented and organized Claims Payment Specialist to manage claims from the time they are received through the billing stage. This role works closely with internal teams, physician offices, and other partners to obtain missing documentation, resolve held claims, and make sure claims are complete and ready for billing. What You'll Do Review and thoroughly inspect claims as they are received Manage claims through the billing stage and ensure all required information is complete Identify missing documentation or information and actively work to obtain what's needed Monitor held claims and consistently follow up until issues are resolved Work with physician offices, hospitalists, Directors of Nursing, Regional Directors, billing teams, admission coordinators, and other partners Attach required documentation to patient electronic records Maintain an organized workflow and address outstanding tasks throughout the day Enter required non-visit activity accurately and on time Provide professional and responsive customer service when working with internal and external partners Why This Role Stands Out Opportunity to play an important role in keeping the billing process moving Work closely with multiple teams across the organization Position where attention to detail and follow-through make a direct impact Supportive team environment with a strong focus on accuracy and timely results What You Bring High school diploma or GED required One year of related administrative or business experience is preferred Business college education or training is a plus Experience with Microsoft Word and Excel Strong computer skills and ability to learn and use multiple software applications Home health or healthcare experience preferred Knowledge of medical terminology preferred Ability to type approximately 50 words per minute preferred Strong organizational, time management, communication, and phone skills High attention to detail and accuracy Ability to follow up on outstanding items professionally and consistently Positive, flexible, and cooperative approach Strong follow-through and ability to manage multiple priorities