
Claim Resolution Specialist
4 days ago
As a Claims Resolution Specialist, you play a pivotal role in ensuring timely and accurate reimbursement from insurance companies and patients. Your responsibilities include navigating complex billing and coding rules to resolve outstanding medical claims.
Key Responsibilities:- Initiate calls to insurance companies to inquire about denied claims status.
- Maintain thorough records of interactions and follow-up actions.
- Re-submit claims with corrected information or appeal denials as needed.
- Communicate denial statuses and resolution efforts with patients and internal stakeholders.
Effective denial management is crucial for healthcare providers to recover revenue from claims. By streamlining the revenue cycle, we can enhance cash flow and patient relationships through clear communication.
Required Skills:- Excellent communication and negotiation skills.
- Ability to analyze and interpret complex billing and coding rules.
- Strong organizational and time management skills.
- Proficiency in claims processing software.
Becoming a skilled Claims Resolution Specialist can bring numerous benefits, including:
- Improved career prospects and job security.
- Increased earning potential.
- Personal satisfaction from resolving complex claims issues.
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