MedData Incorporated Hiring for TPL Claims Representative at The Woodlands, TX Full Time

MedData has an excellent career opportunity available as a Claims Representative on our Third Party Liability team. This position has the ability to be a work form home opportunity. The schedule for this FT role is Monday – Friday, between the hours of 7am – 7pm (40 hr/wk).

POSITION OVERVIEW

The purpose of this position is to investigate, facilitate and coordinate benefits for accident claims from auto, home or other liability insurance policies.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement

Review and research accident claims to investigate possible leads

Bill no-fault and third-party liability carriers when appropriate. Requests documentation from insurance representatives when no no-fault insurance exists

Review and research insurance claims to determine possible payment sources

Contact various sources including insurance professionals, patients, and other parties to verify relevant data

Coordinate with payors to ensure appropriate filing guidelines are met for reimbursement

Request appropriate information, both verbally and written, from appropriate parties to ensure proper claim disposition

Maintain and update payors on denied claims

Ensure that appropriate billing guidelines and standards are met based on payor and/or state

Make written or verbal appeals to payers on denied claims

Obtain claim status and gathering supporting documentation to submit appeals

Secure documentation from medical providers, insurance companies, police departments, and patients, and accurately update pending liability cases with new information obtained from the documents

Obtain bills and medical records from medical providers and send them to insurance companies for processing.

Verify information obtained from patients and medical providers regarding insurance coverage with insurance companies for accuracy

Assist patients in the filing of first party claims

Administer hospital liens for third party liability claims

Administer liens in compliance with state lien statute parameters regarding lien format, content, and notification requirements

QUALIFICATIONS AND REQUIREMENTS

High School Diploma or GED

Thorough knowledge of the liability claims adjudication process

Ability to communicate effectively verbally and in writing

Proven ability to be assertive in order to proactively resolve issues

Working knowledge of computer functions including the internet and computer software such as Microsoft Office Suite and the ability to learn in-house computer applications

This job description is to serve as a guide but no way is it to be considered a comprehensive list of task, duties and responsibilities that will be required by the employee.

To join our team of 2,000 employees and growing, please apply directly to this posting.

MedData is an Equal Opportunity Employer