Claims Resolution Specialist

Starting at $17.00 per hour

Responsibilities:

• Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing. Contact responsible party to establish reason for non-payment document in system all verbal and written communication relative to open account balance, and institute timely follow-up with responsible party as a result of last contact to assure progress in resolving account with payment.
• Maintain consistent, productive, and timely follow-up, as often as is needed to collect on the account. Time between account follow up is not to exceed 30 days.
• Maintain a productivity of 20 to 25 accounts per day. This is subject to change based on volume changes and operational needs.
• Make outgoing calls to patients, insurance companies and attorneys regarding claim status in order to reduce both outstanding receivables.
• Regularly communicate with hospital staff and department management on any accounts receivable issues/problematic payor trends.
• Identify and resolve issues impacting the timely collection of open receivables.
• As necessary, request account adjustments as identified via write off requests and refund requests.
• Notify database operations of changes or additions to specific payor, plan, contract, address, or other pertinent information as necessary.
• Meet the expectations and goals for productivity and collections targets as set forth by management.
• Performs other duties or special projects as assigned.

Qualifications:

• High School Diploma or Equivalent
• One year of experience (2+ years for remote candidates) within a medical billing, medical collecting or claims processing role.

• Computer Skills
• Microsoft Office:
• Outlook
• Excel
• Ability to work with multiple programs simultaneously.
• Good interpersonal, oral and written communication skills.
• Previous experience in metrics based role, where production/quality standards are upheld.
• Time management and organizational skills
• Proven experience with investigative research.
• Ability to work independently and as part of team to reach mutually established goals.
• Attention to detail
• Flexibility and being open to change
• This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

Additional Data:

Your benefits as a Claims Resolution Specialist:

• An extensive and thorough paid orientation program.
• Paid Time Off (PTO) and Extended Illness Days (EID).
• Health, Dental, and Vision Insurance; Life insurance; Prescription coverage.
• A 401(k) retirement plan with company match.
• No Required Weekends

• Office Environment
• Sitting for extended periods of time
• Ability to lift weight up to 35 lbs.