Medical Billing & Claims Specialist

About TruHearing TruHearing 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. TruHearing 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. TruHearing 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. About the Opportunity: 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 TruHearing's provider network. What will you be doing? 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 TruHearing's proprietary data system according to compliance requirements and TruHearing standards. Demonstrate an understanding of applicable patient claims and insurance benefits by providing specific insurance information to claimants, health plans, and members of the TruHearing 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 TruHearing's proprietary data system. Prepare basic insurance claims by transferring data from TruHearing's proprietary data system to the clearinghouse so payers receive timely and accurate claims. Confirm that payments received from TruHearing'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. What skills do you need to bring? In addition to exhibiting the TruHearing 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 collaborates with others to accomplish assignments and objectives. Using Technology - Uses basic IT tools or software. Resilience - Maintains energy in the face of occasional strenuous work demands. Analytical Thinking - Analyze basic or common situations to identify patterns. Resilience - Maintain energy in the face of occasional strenuous work demands. Subject Matter Expertise - Applies expertise in common situations that present limited difficulties, working with a moderate level of guidance. Problem Solving - Solves known problems with proven solutions, escalates unusual or novel problems. What education or experience is required?Required: High School Diploma or equivalent. Three (3+) years' experience working in the healthcare industry, preferably directly with insurance companies. Medical Claim submission experience Medical Prior authorization experience Medical benefit verification experience Managed Care experience Fee for Service Claims experience Experience working with claims systems and clearinghouses Preferred: Knowledge or experience with Availity, TriZetto, Waystar, QNXT. Claims adjudication experience Degree or Certification for medical billing. What benefits are offered? TruHearing offers a generous compensation and benefits package including health coverage, a fully vested 401k match, education assistance, fully paid long and short-term disability, paid time off and paid holidays. We are conveniently located across the street from the Draper FrontRunner station and subsidize the cost of a UTA pass with access to FrontRunner, TRAX and regular bus service - employee cost is less than $2 per day. You'll work in an exciting and fun environment and have the opportunity to grow with us. Equal Opportunity TruHearing is an Equal Opportunity Employer who encourages diversity in the workplace. All qualified applicants will receive consideration for employment without regards to race, color, national origin, religion, sex, age, disability, citizenship, marital status, sexual orientation, gender identity, military or protected veteran status, or any other characteristic protected by applicable law.

Created: 2026-03-04