Insurance Claims Specialist

Job Summary

Managing insurance claims for clients, the full-time remote Account Resolution Specialist III will ensure timely payment processing, handle claim denials and appeals, and maintain accurate financial records for healthcare organizations.

Key responsibilities

• Submit and review medical claims to ensure compliance with federal, state, and payer-specific requirements
• Investigate claim errors and denials, and follow up with payers to resolve outstanding accounts receivable
• Prepare and submit appeals with supporting documentation in accordance with payer guidelines

Required qualifications

• High school diploma or equivalent
• Minimum 2 years of experience in securing medical claim payments and managing claim follow-up
• Experience with EMR/EHR systems such as Meditech, Epic, or similar platforms
• Strong knowledge of ICD-10, CPT/HCPCS, and payer guidelines
• Proficiency in Microsoft Office Suite and various desktop applications