
Healthcare Claims Resolution Specialist
4 days ago
Job Title: Healthcare Claims Resolution Specialist
In this role, you will be responsible for handling all aspects of healthcare claims resolution, working closely with internal teams to ensure timely and effective communication with clients and insurers. Your goal will be to resolve claim denials, rejections, or short payments in a professional and efficient manner.
Responsibilities:
- Handle all AR calling responsibilities under the US Healthcare / RCM (Revenue Cycle Management) process.
- Work primarily on Physician Billing / Denial Management, including follow-up with insurance companies.
- Analyze and resolve claim denials, rejections, or short payments.
- Maintain accurate documentation of actions taken on patient accounts.
- Work in coordination with the internal team to escalate unresolved claims as per protocol.
- Ensure timely and effective communication with clients and insurers to expedite claim resolutions.
- Provide detailed status reports on aging claims and denied claims.
- Deliver quality results by adhering to SLA and compliance requirements.
- Update and maintain patient account records using healthcare management software.
Required Skills and Qualifications:
- Experience in healthcare claims resolution or related field.
- Strong communication and negotiation skills.
- Ability to work effectively in a fast-paced environment.
- Proficiency in healthcare management software.
Benefits:
Our company offers a competitive salary and benefits package, including opportunities for career growth and professional development.
Other Requirements:
You must be flexible to work in Night Shifts (US Time Zone).
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