Unpaid Claims Representative (Administrative)

Nystrom & Associates, Ltd. is a team of mental health professionals that specialize in psychiatric evaluations, clinical social work, and family therapy. We are committed to helping patients in our community who are experiencing personal, emotional, marriage, family, or psychological problems. Founded in 1991, we offer an intensive outpatient chemical dependency program, psychological testing, and behavioral health and medication management services.
As an Unpaid Claims Representative with Nystrom & Associates, Ltd. you will partner with our patients, payers, and clinicians to assist in resolving unpaid claims. This role will play a vital part in the collection of payments from our insurance providers, ensuring accurate claim processing, detailed account management, and timely appeal submission for any flagged claim issue.

This role is fully remote based in Wisconsin.

Hours: General Daytime hours

Job Duties:

Resolve unpaid claims for each insurance assigned.
A claim is not resolved until payment is received from all applicable insurance companies.
Investigate each claim thoroughly with the appropriate steps taken to rebill, correct, and appeal when necessary.
Make outbound phone calls to insurance companies for unpaid, denied, or rejected claims.
Resolve inquiries from Providers, Patient Financial Services, Insurance Team, etc.in a timely manner.
Maintain excellent understanding of Insurance, EOB, and Billing rules.
Investigate and resolve providers aging as assigned by management.
Perform other duties as assigned.

Job Expectations

Recognize trends and patterns with insurance companies.
Excellent verbal and written communication skills.
Flexibility and adaptability.
Must be able to multi-task throughout the day.

Qualifications:

Familiarity with insurance company guidelines and/or billing rules.
Detail oriented, flexible problem solver; maintains a positive attitude.
Computer Experience required, Microsoft Windows, Excel, Word, Outlook
Excellent Communication and Organization skills
Flexibility
High school graduate or equivalent.