Claims Resolution Specialist

Job Summary

To support a growing team, the full-time Claims Resolution Specialist will review medical insurance claims for resolution and payment, resolve inquiries and payment denials from insurance providers, and contact carriers to collect on open account balances while working remotely.

Key responsibilities

• Review all medical insurance claims for resolution and payment
• Resolve incoming inquiries or payment denials from insurance providers by researching and responding to documentation requests
• 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 preferred
• Preferred experience in Medical Oncology, Radiology, Radiation, Laboratory, or Pathology