
Claims Resolution Expert
5 days ago
This position involves reaching out to insurance companies and patients to follow up on outstanding medical claims, ensuring accurate reimbursement. As a Medical Claims Specialist, you will navigate complex billing and coding rules, playing a critical role in denial management.
Key Responsibilities:- Follow-up and Resolution:
- Contact insurance companies to inquire about denied claims status.
- Documentation:
- Maintain thorough records of all interactions and follow-up actions.
- Re-submittal:
- Involved in re-submitting claims with corrected information or appealing denials.
- Communication:
- Communicate with patients and internal stakeholders about denial statuses and resolution efforts.
- Increased Revenue:
- Effective denial management helps healthcare providers recover more revenue from claims.
- Reduced Turnaround Time:
- Speeding up the revenue cycle through denial management can improve cash flow.
- Improved Patient Relationships:
- Medical Claims Specialists often communicate with patients to explain denial reasons and ensure understanding.
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