Medical Billing & 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.

** Only open to candidates in Colorado at this time.**

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.
• Resolve claim processing issues with insurance carriers via phone call, email, or online portals.
• Prepared and submit insurance claims for health plans with multi‑step, nuanced, or complicated processes which require additional application of billing codes and process knowledge.
• Review and apply payments received from the health plans when the payment is complicated, nuanced, or requires special training.
• Document and track unpaid/underpaid health plan claims using secure spreadsheets for accurate reporting.
• Identify claims processing trends and report trends to management.
• File insurance appeals on behalf of patients.
• Prepare and send invoices to patients through mail.
• Analyzes patient claims and appeals for approval or denial.

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 in the right moment.
• Teamwork – Proactively assists and…