Claims Resolution Specialist

Job Summary

Reviewing medical insurance claims for resolution and payment, the full-time Claims Resolution Specialist will handle inquiries and payment denials from insurance providers while working remotely.

Key responsibilities

• Review all medical insurance claims to ensure proper resolution and payment
• Respond to documentation requests from insurance carriers in a timely manner
• Contact insurance carriers to collect on open account balances

Required qualifications

• Excellent knowledge of insurance carrier billing and reimbursement, including medical terminology, ICD-9, and CPT codes
• In-depth understanding of explanation of benefits (EOB)
• At least one year of prior medical billing or medical collections experience
• Experience with EMR or GE Centricity Practice Management software is preferred
• Experience in Medical Oncology, Radiology, Radiation, Laboratory, or Pathology is preferred