Job Opening

Clearinghouse Specialist

 

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Did you know that we spend over 2,000 hours at work in a year? We want Clinicient to be a place where people from different backgrounds and experiences can do their best work, a place where our people belong, a place where we are people not titles, and a place where we want everyone to fulfill their potential. So, what do you think? Is this a place you would like to work? If so, we would love to hear from you.

Role Summary

The Zirmed Specialist role focuses on working rejected claims at our clearinghouse. This is a critical function in the revenue cycle.

Essential Responsibilities

    • Resolve clearinghouse rejections maintain rejection numbers within outlined SLA.
    • Utilize all tools available to understand status of a claim at the 30 to 45 day mark depending on the payer; check websites, IVR systems, and phone calls to the payor as needed.
    • Work claims as prioritized by the team based on knowledge of the client, their status with payers and knowledge of difficult payers for that client (WC, Medicaid, TPA’s, etc).
    • Communicate problems with payers to your team lead and determine if client involvement is needed in understanding their relationship to the payer.
    • Keep claim regulation knowledge up to date.
    • Be comfortable with working on multiple projects simultaneously.
    • Recognizes, analyzes and reports on data related to underpayments, denials, revenue opportunities and revenue leakage.
    • Responds to client tasks in regard to AR or patient accounts.
    • Be very inquisitive in regards to the intentions of the client and insurance company.
    • Be passionate and assertive in problem solving.

Knowledge, Skills and Abilities

    • Must be a role model of Clinicient’s Core Values: People; Client Focused; Trust; Innovation; Fun; Excellence and Teamwork.
    • Competencies: Optimizes Work Processes, Customer Focus, Nimble Learning, Collaborates, and Instills Trust.
    • Experience in managed care contracts, reconciling patient accounts, and balancing payment transactions against contract rates and terms is strongly desired.
    • Keen attention to detail with ability to spot trends and proactively reduce denials.
    • Critical thinker with demonstrated ability to perform root cause analysis, problem solve, prepare and implement action plans and lead improvement initiatives.
    • Strong oral and written communication skills.
    • Proficiency in the use of PCs and MS Office suite.
    • Ability to adapt to a changing and dynamic environment.
    • Comfortable working in both individual and team settings.
    • Ability to interpret and implement regulatory standards.

Education and Experience

    • Bachelor’s degree preferred.
    • 1 to 2 years’ experience in insurance, healthcare or medical billing.

About Clinicient

Our Vision

Clinicient’s vision is to improve 20 million lives by 2025. This is our higher purpose and what drives us to help therapists and clinics thrive in all aspects of their business.  Get inspired by how therapists are improving lives every day.

Our Mission

Our mission is a noble one: to reward great care through partnerships with the clinicians we serve. We do this by combining the clinical tools that allow our clients to efficiently deliver and document care and the financial tools to maximize reimbursements.

Benefits and Perks

Clinicient offers a generous benefits plan to all employees. In addition, we offer a $100.00 monthly transportation reimbursement, 401k plan, wellness program, and paid time-off. Eligible employees can also take advantage of a four-week paid parental leave policy, which is for moms and dads. We are in the heart of Downtown, Portland, Oregon and offer a flexible and creative workplace that includes a game room, fully stocked fridge, local microbrews, and many fun events throughout the year.

Clinicient is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law.

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