Claims Resolution Specialist

Job Summary

Working remotely in a full-time capacity, the Claims Resolution Specialist will manage client and insurance billing, perform analysis on claim rejections and denials, and ensure compliance with revenue cycle processes to facilitate timely payments.

Key responsibilities

• Analyze and investigate claim rejections and denials to identify trends and improve outcomes
• Follow up on claims with no payer response and take appropriate actions to facilitate payment
• Maintain knowledge of billing codes and payer requirements to ensure accurate processing of claims

Required qualifications

• Must have strong computer skills, including proficiency in Excel and electronic documentation systems
• Ability to work independently and collaboratively to achieve team goals
• Critical thinking skills to apply appropriate discernment in job functions
• Understanding of the healthcare billing or revenue cycle environment
• Experience in healthcare billing or medical coding education is preferred but not required