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Claims Resolution Specialist
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Job Description
- Req#: 3876213
Employer Industry: Healthcare Revenue Cycle Management
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on the financial health of the organization
- Engage in process improvements to enhance revenue cycle performance
- Work with a team of professionals dedicated to ethical standards and integrity
What to Expect (Job Responsibilities):
- Submit and track insurance and patient claims for government and commercial payers
- Perform timely follow-up on unpaid or denied claims to ensure proper reimbursement
- Conduct root cause analysis on recurring denials or payment issues and escalate trends as needed
- Collaborate with clinical, billing, and coding staff to resolve claim issues and ensure accurate submission
- Maintain clear and thorough documentation of all claim-related activities and communications
What is Required (Qualifications):
- High school diploma or equivalent required; associate's or bachelor's degree in healthcare administration, business, or related field preferred
- 2+ years of experience in medical billing, claims follow-up, or revenue cycle management required
- Working knowledge of government and commercial payer guidelines, medical terminology, and insurance billing practices
- Experience with Electronic Health Record (EHR) and Practice Management systems
- Proficiency with Microsoft Office Suite, particularly Excel and Outlook
How to Stand Out (Preferred Qualifications):
- Experience communicating with patients regarding billing questions and payment options
- Understanding of claim adjudication, payment posting, and denial management processes
- Strong data entry and documentation skills
- Ability to work independently and adapt in a fast-paced environment
- Detail-oriented with strong analytical skills
#HealthcareRevenueCycle #ClaimsManagement #CareerOpportunity #TeamPlayer #ProcessImprovement
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