Hiring Guide for a Medical Claims Specialist in Denver
The American Medical Association has identified a 30% shortage of medical coders and claims specialists, mainly caused by numerous retirements and a scarcity of new entrants in the field.
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How are U.S. organizations dealing with the shortage of medical coding and claims staff?
According to a spring 2023 report by the American Medical Association, there’s a 30% shortage in the medical coding and claims workforce. This is primarily due to a wave of retirements among experienced professionals and not enough new people stepping in to fill these roles.
To tackle this staffing issue, many American organizations are turning to outsourcing. If you’re thinking about going this route, make sure to go with a provider that prioritizes ethical practices, a positive work environment, and community involvement.
Also, don’t forget about data security. Look for providers with strong endpoint security, ISO certification, and robust Business Continuity Plans (BCP). With these measures in place, you can rest easy knowing your data and operations are secure.
A Medical Claims Specialist Denver position requires expertise in processing claims, detecting discrepancies, and authorizing payments for healthcare providers in the Denver area. Here’s a closer look at their must-have skills:
- Medical billing and coding: They ensure that healthcare services are accurately coded for billing and insurance purposes, utilizing server control systems to match codes with patient services.
- Documentation of medical claims and negligence: Specialists meticulously document claims and any instances of negligence, ensuring all data is securely stored and easily accessible for review.
- Detection of inaccurate claims: They are adept at identifying discrepancies in medical claims through search algorithms and human review to prevent errors and security breaches.
- Medical claim reconciliation: They reconcile claims by responding quickly to mismatches and ensuring all charges and payments are accurately processed.
- Processing of medical claims receipts: Specialists manage the receipts of claims, ensuring all necessary documentation is organized and available when required by the server.
- Authorization of payments: They authorize the final settlements of claims, ensuring timely and accurate payments to healthcare providers based on verified request results.
- Medical claims tool proficiency: They must have experience in using Trizetto Facets, Availity, Change Healthcare, Kareo, Optum360, and other request management tools.
A guide to interviewing Medical Claims Specialist for Denver:
What to ask in a job interview
When hiring a Medical Claims Specialist for Denver, it’s crucial to assess their technical know-how. Also, bear in mind that soft skills are just as important. To get a good sense of their capabilities during the interview, ask these questions and pay close attention to how they respond:
- Can you walk me through your process of handling claims?
- How do you keep yourself updated with the latest regulations and laws pertaining to insurance claims?
- With multiple clients requiring attention, how do you ensure all demands are met efficiently?
- Could you share some insights from your experiences dealing with fraudulent claim investigations?
- Have you ever caught a potential issue before it escalated? Could you tell me more about that instance?
- If you have any, I’d love to hear about your experience handling international claims.
How much does outsourcing a Medical Claims Specialist for Denver cost?
Hiring a Medical Claims Specialist locally in Denver comes with various costs linked to their experience, skills, and location.
Beyond the salary, you’ll need to consider additional expenses like benefits and office overheads, which could increase your total by at least 30%. Using job posting sites like Seek, Monster.com, or LinkedIn or working with recruitment agencies like Hays could add another 20% to the first-year salary.
To potentially cut down on costs, you might think about outsourcing to places like the Philippines, Colombia, or India. Tools like Cloudstaff’s Teambuilder can help you figure out how much you could save.
Outsourcing opens up a worldwide talent pool, allowing you to build your team cost-effectively without the substantial overheads associated with local hiring.
Steps to hiring Medical Claims Specialists with Cloudstaff
Here’s how Cloudstaff makes it easier for Denver companies to hire remote Medical Claims Specialists.
Match
We use a database of 700,000 candidates and AI technology to find the right match for you.
Interview
We streamline the selection process to ensure you meet only the best candidates.
Offer
We handle all local employment paperwork, from offers to contracts.
Enable
On day one, your new hires have everything they need, including equipment and secure logins.
Induct
Our thorough legal induction ensures all new hires are compliant from the start.
Train
We provide access to training materials and to our learning platform, CS Academy, for ongoing talent development.
Manage
Our team supports productivity, staff relations, and growth, helping your workforce thrive.
Onboarding & training Medical Claims Specialists at Cloudstaff, your Employer of Record
Thinking about outsourcing Medical Claims Specialists for your Denver business? Navigating remote staffing regulations across different countries can get tricky, but that’s where Cloudstaff steps in. We take care of payroll, taxes, and compliance issues in places like the Philippines, Colombia, and India, so you can concentrate on managing your remote team effectively.
A good cultural fit is crucial. That’s why we look for candidates who are not only fluent in English but also blend well with Denver business culture.
When it comes to onboarding, Cloudstaff makes sure your remote Medical Claims Specialists mesh seamlessly with your Denver team. We establish clear guidelines, provide training, and support them with US-style management practices. Plus, with regular check-ins from our Client Growth Partners, we offer continuous support to help your team scale and succeed.
What makes Cloudstaff’s remote staffing solutions different from other outsourcing models?
Cloudstaff stands out in the outsourcing industry with a distinctive approach to remote staffing.
Cloudstaff’s remote staffing solutions
Ethical outsourcing
- Committed to safety, employee growth, and a celebrated work culture
- Transparent pricing, and comprehensive benefits
- Robust Business Continuity Planning (BCP)
#1 Workplace
- Your trusted co-pilot to find the best talent
- Our recruitment experts offer access to over 700,000 skilled remote professionals worldwide, supported by our comprehensive Cloudstaff Academy
Operational brilliance
- Dedicated to your remarkable growth, our Client Growth Partners are always there for you whenever you need them
- We provide exceptional staff, mobilize teams, and manage performance to move your business forward
Enterprise-grade outsourcing
- Significant investment in advanced technology and platforms
- Unrivaled security features tailored for enterprise need
- Leading-edge in tech-enabled solutions with top-tier remote work technology and AI talent augmentation
- We have a Google-alum Chief AI Officer who is advancing our proprietary AI to enhance matching accuracy, ensure a private generative AI environment for secure staff usage, and develop specialized AI toolkits for various industries.
Other outsourcing models
Direct contracting
- Compliance issues due to legal concerns
Freelance hiring
- Tax obligations not met
- Lack of full-time commitment
Traditional outsourcing
- Ethical considerations
- Potential business risks
- Limited post-sales support
Establishing a local entity
- Initial investment requirement of approximately $250k
- Additional considerations for local equipment procurement
- Necessitates investment in local human resources and cultural integration
- Local bureaucratic hurdles
Retaining top Medical Claims Specialists in your Denver company
Involves more than just acknowledging their skills – it’s about making them feel appreciated. Cultivate a people-first environment that offers excellent perks, rewards, opportunities for advancement, inclusive events, and supports a healthy work-life balance to ensure every team member feels vital.
Check out how you can save up to 70% vs traditional hiring costs with our TEAM BUILDER.
Download a custom remote staffing business case tailored to your hiring needs.
Struggling with hiring challenges and tight budgets?
Let us help you find the ideal Medical Claims Specialist.
