Insurance Claims Specialist

Tru Hearing is a rewarding, fun and friendly, mission-based organization that makes a real difference towards improving people’s lives. Our employees enjoy a positive working environment in a company that has experienced rapid growth. We offer a comprehensive benefits package, educational assistance, and opportunities for advancement.

Tru Hearing is the market leader and a force for positive change in the hearing healthcare industry. We reconnect people to the richness of life through industry-leading hearing healthcare solutions. We work with insurance companies, hearing aid manufacturers, and healthcare providers to reduce prices and expand access to better hearing care and whole-body health.

Tru Hearing is part of the WS Audiology Group (WSA), a global leader in the hearing aid industry. Together with our 12,000 colleagues in 130 countries, we invite you to help unlock human potential by bringing back hearing for millions of people around the world. The WSA portfolio of technologies spans the full spectrum of hearing care, from distinct hearing brands and digital platforms to managed care, hearing centers and diagnostics locations.

This role exists to work with patient health plans to coordinate the patients’ claims and insurance benefits when purchasing hearing aids through a provider in Tru Hearing’s provider network.

• Confirm patient’s insurance coverage, demographic information and other details with health plans via outbound phone calls, web chats, or online portals.
• Accurately document patient hearing aid benefit details, and patient information in Tru Hearing’s proprietary data system according to compliance requirements and Tru Hearing standards.
• Demonstrate an understanding of applicable patient claims and insurance benefits by providing specific insurance information to claimants, health plans, and members of the Tru Hearing insurance department.
• Validate patient demographic information with health plan payers (e.g., Medicare, Medicaid, private, and commercial) via outbound phone calls, web chats, or online portals.
• Confirm insurance claim payments are paid correctly.
• Apply insurance payments to patient accounts through Tru Hearing’s proprietary data system.
• Prepare basic insurance claims by transferring data from Tru Hearing’s proprietary data system to the clearinghouse so payers receive timely and accurate claims.
• Confirm that payments received from Tru Hearing’s Accounting Department are processed and accounts are reconciled.
• Complete a log of submitted claims and track to ensure timely payment from health plan partners.

In addition to exhibiting the Tru Hearing Values of Going Beyond Together, Pioneering for Better Solutions, and Passion for Impact
, this role requires the following:

• Accountability – Operates autonomously in most situations, communicates limits and needs.
• Quality – Consistently meets quality standards of the organization with limited assistance.
• Productivity – Consistently meets productivity standards of the organization with limited assistance.
• Initiative – Acts proactively and independently in common situations, asks appropriate questions, offers appropriate suggestions.
• Customer Focus – Develops customer relationships over time, provides services and offerings utilización en el right moment.
• Teamwork – Collaborates with others to accomplish standard, documented processes.
• Using Technology – Uses basic IT tools or software.
• Resilience – Maintains energy in the face of occasional strenuous work demands.

• High School Diploma or equivalent.
• One (1+) years’ experience working in the healthcare industry, preferably directly with insurance companies.
• Medical Claim submission experience
• Medical Prior authorization experience
• Medical benefit verification experience

• Two (2+) years’ experience working in the healthcare industry, preferably directly with insurance companies OR one (1+) years’ experience working as a Level I системой Insurance Specialist at Tru Hearing.
• Managed Care experience
• Fee for Service Claims experience
• Knowledge in Availity, Tri Zetto,…