Claims Resolution Specialist
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Job Summary
Working remotely in a full-time capacity, the Claims Resolution Specialist will process medical claims, conduct AR follow-up, and manage appeals while adhering to established best practices and industry guidelines.
Key responsibilities
- Conduct AR follow-up on front-end scrubs and back-end denials, utilizing the Athena billing platform
- Review and clear claim edits in the system, addressing registration, insurance, and charge issues
- Demonstrate a detailed understanding of EOBs and insurance denials, including appeals processing across payer categories
Required qualifications
- 3+ years of experience in claims resolution or medical billing
- Minimum of 2 years of documented experience on the Athena billing platform is highly preferred
- Working knowledge of CPT, ICD-10, and medical terminology
- Solid background in AR and overall Revenue Cycle policies and procedures
- Bachelor's degree or medical billing certificate preferred
Complete Job Description
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