Financial Claims Resolution Specialist
1 week ago
Your Role
- Responsibilities include working on assigned claims and running reports to identify potential issues that require follow-up action.
- Ensuring timely resolution of claims to prevent write-offs.
- Ongoing contract adjustments, claim analysis and quality control activities.
- Analyzing previous actions taken on claims; taking corrective action as necessary to improve processes.
- Identifying opportunities to enhance the follow-up process and make recommendations for improvement.
- Maintaining a high level of knowledge about various scenarios and staying up-to-date with new updates.
- Conducting self-audits to ensure compliance with established standards.
- Reviewing claims thoroughly to resolve them efficiently before assigning them to other teams.
Key Skills Requirements
- 2+ years of experience in AR Follow-ups (Voice) is required.
- Strong understanding of billing scrubbers, CH/Payer Rejections and related RCM functions.
- Proven track record of achieving good cash collection/resolution rates.
- Expertise in commercial federal payers, basic coding concepts and CARC codes.
- Familiarity with resolving Auto, WC, IPAs etc. cases.
- Excellent listening and problem-solving skills.
- Ability to interact positively with team members, peers and seniors.
- Strong communication skills, both written and verbal.
- Knowledge of HIPAA guidelines and data security best practices.
Benefits
This role offers the opportunity to work in a dynamic environment and contribute to the success of our organization.
We are looking for a motivated individual who can thrive in a fast-paced setting and take ownership of their work.
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