Medical Claims Resolution Specialist

5 days ago


Rajkot, Gujarat, India beBeeClaims Full time ₹ 6,00,000 - ₹ 8,00,000

As a Medical Claims Resolution Specialist, you will play a vital role in ensuring accurate reimbursement for healthcare providers. Your responsibilities will include contacting insurance companies to follow up on outstanding medical claims and navigating complex billing and coding rules.

Key Responsibilities:
  • Follow-up and Resolution:
  • You will initiate calls to insurance companies to inquire about the status of denied claims, working closely with patients and internal stakeholders to resolve issues efficiently.
  • Documentation:
  • A thorough record of all interactions and follow-up actions will be maintained, ensuring transparency and accountability throughout the process.
  • Re-submittal:
  • You may be involved in re-submitting claims with corrected information or appealing denials, advocating for your clients' interests and rights.
  • Communication:
  • You will communicate effectively with patients and internal stakeholders about denial statuses and resolution efforts, fostering strong relationships and trust.
The Importance of Effective Denial Management:

Denial management is a critical aspect of the revenue cycle, directly impacting healthcare providers' cash flow and patient relationships. As a Medical Claims Resolution Specialist, you will contribute to increased revenue recovery, reduced turnaround times, and improved patient relationships through effective denial management and AR calling.



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