
Claims Resolutions Manager
1 day ago
Claims Resolution Specialist
Primary Responsibilities:
- Engage in outbound calls to insurance companies to follow up on outstanding claims.
- Understand and resolve claim denials or rejections to ensure timely payment.
- Verify patient insurance information and update accounts accordingly.
- Document call details, follow-up actions, and claim status for future reference.
- Maintain a high level of accuracy in updating accounts and handling claims.
- Collaborate with internal teams to escalate unresolved issues and ensure resolution.
- Meet or exceed productivity targets.
Additional Responsibilities:
- Stay informed about payer policies, guidelines, and industry developments.
- Provide feedback regarding process gaps or areas for improvement.
- Ensure compliance with relevant regulations and confidentiality policies.
- Maintain professional communication with insurance representatives and team members.
Job Requirements:
- Education: Degree in any discipline (Commerce or Healthcare-related fields preferred).
- Experience: 1 to 6 years in AR calling, medical billing, or healthcare revenue cycle management.
- Willingness to work night shifts as required by US process standards.
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