Claims Resolution Analyst

Job Summary

Handling a high volume of third-party claims, the full-time Claims Resolution Analyst will ensure accurate information is submitted to payers, initiate corrective actions for claim issues, and document all follow-up activities while working remotely.

Key responsibilities

• Manages the submission of third-party claims and initiates corrective actions to resolve issues preventing claims processing
• Completes daily claims submissions and resolves rejections from third-party payers, documenting all actions taken
• Follows up on paid and unpaid claims to expedite payments, determining reasons for nonpayment and taking appropriate actions

Required qualifications

• High school diploma required; Associate Degree in a business-related field preferred
• One to two years of third-party claims management and/or billing experience in a healthcare revenue cycle environment
• Extensive knowledge of third-party insurance carriers and their billing and reimbursement requirements
• Proven ability to perform detailed analysis quickly and accurately in a high-volume environment
• Familiarity with Microsoft Office and ability to navigate various payer websites and web-based applications