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Claims Resolution Specialist
3 weeks ago
The role of an insurance claims resolution specialist is to contact insurance companies and patients to follow up on outstanding medical claims, ensuring accurate reimbursement.
This process involves navigating complex billing and coding rules. The specialist plays a critical role in denial management by:
- Initiating calls to inquire about denied claims status;
- Maintaining thorough records of all interactions and follow-up actions;
- Re-submitting claims with corrected information or appealing denials;
- Communicating with patients and internal stakeholders about denial statuses and resolution efforts.
DENIAL MANAGEMENT AND HEALTHCARE PROVIDERS:
- 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: Specialists often communicate with patients to explain denial reasons and ensure they understand the process.
Benefits:
- Critical Role in Denial Management
- Improved Communication Skills
- Excellent Problem-Solving Abilities
About this Opportunity:
This opportunity requires excellent communication and problem-solving skills, as well as the ability to navigate complex billing and coding rules. If you are a motivated individual who is passionate about helping others, we encourage you to apply.
