
Insurance Claims Resolution Specialist
3 days ago
Job Title: Insurance Claims Resolution Specialist
About the Role:We are seeking a skilled Insurance Claims Resolution Specialist to join our team. In this role, you will be responsible for following up with insurance companies on outstanding claims, working on denials, rejections, and unpaid claims to ensure resolution, initiating appeals and re-submissions where required, maintaining clear and accurate documentation of calls and actions taken, meeting performance metrics for call quality, productivity, and claim resolution, and ensuring compliance with HIPAA and internal process guidelines.
Key Responsibilities:- Follow up with insurance companies on outstanding claims in a timely and professional manner.
- Analyze and resolve complex claim issues, including denials, rejections, and unpaid claims.
- Initiate appeals and re-submissions as necessary to ensure claim resolution.
- Maintain accurate and detailed records of calls and actions taken.
- Meet or exceed performance metrics for call quality, productivity, and claim resolution.
- Bachelor's degree in Business Administration, Finance, or related field.
- Minimum 2 years of experience in insurance claims resolution or related field.
- Strong analytical and problem-solving skills.
- Excellent communication and interpersonal skills.
- Ability to work independently and as part of a team.
- Familiarity with HIPAA and internal process guidelines.
- A competitive salary and benefits package.
- The opportunity to work with a dynamic team and contribute to the success of the organization.
- Professional development and growth opportunities.
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