We have other current jobs related to this field that you can find below

  • Claims Resolution Associate

    4 days ago

    Edmond, Oklahoma, United States Progressive Insurance Full time

    As a claims resolution associate, you will play a vital role in ensuring that claims are processed effectively for our clients. Collaborating with various members of our claims department, your responsibilities will include managing administrative duties, drafting settlement documents, and handling correspondence. You will also engage with clients, service...

  • Claims Support Specialist

    1 month ago

    Edmond, United States Progressive Insurance Full time

    As a claims support specialist, you'll help ensure claims are resolved efficiently for our customers. Supporting complex roles within our claims team, you'll handle administrative tasks, prepare settlement drafts and correspondence, in addition to corresponding with customers, vendors, medical providers, attorneys and law enforcement. Applications will be...

  • Insurance Claims Specialist

    3 days ago

    Edmond, Oklahoma, United States MedPro Group Full time

    About MedPro Group - A Premier Insurance ProviderMedPro Group, a subsidiary of Berkshire Hathaway, stands as a leading insurance provider committed to safeguarding our clients and supporting our team members. Our workforce comprises professionals from various fields, united by a shared mission: to protect healthcare practitioners.Role Summary:Evaluate...

  • Customer Support Specialist

    4 days ago

    Edmond, Oklahoma, United States Hobby Lobby Stores, Inc. Full time

    Hobby Lobby Stores, Inc. is seeking a dedicated full-time Customer Support Specialist.Key Responsibilities:1. Deliver exceptional service to retail locations by addressing maintenance inquiries.2. Identify, coordinate, and guide contractors associated with maintenance requests.3. Ensure efficient communication and resolution of issues for retail...

  • Sales Support Specialist

    3 days ago

    Edmond, Oklahoma, United States Love's Travel Stops Full time

    Position OverviewThe Sales Support Specialist plays a crucial role in enhancing customer experience and ensuring seamless operations within the sales department.Key ResponsibilitiesAccount Management: Establish and maintain customer accounts, ensuring all information is accurate and up-to-date.Customer Assistance: Guide clients in effectively utilizing our...

  • International Customer Support Specialist

    4 days ago

    Edmond, Oklahoma, United States Wonderful Citrus Full time

    Position OverviewThe International Customer Support Specialist serves as a vital link between Wonderful Citrus and our global partners. This role is essential in delivering exceptional service that upholds our dedication to international transactions.Key ResponsibilitiesProvide outstanding assistance to international affiliates, ensuring a seamless...

  • Loan Support Specialist

    3 months ago

    Edmond, United States Allegiance Credit Union Full time

    ** Allegiance Credit Union** ** Loan Support Specialist** Oklahoma City, OK 73112 E 5% Performs other job related duties as assigned. Experience One year to three years of similar or related experience. Education A high school education or GED. Interpersonal Skills Work involves much personal contact with others inside and/or outside the organization for...

  • Follow-Up Specialist

    3 months ago

    Edmond, United States Oklahoma Arthritis Center Full time

    Job DescriptionJob DescriptionSalary: Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status. Job Summary:Reviews billing data of unpaid claims. Responsible for calling...

  • Clinic Billing Specialist

    1 month ago

    Edmond, United States Oklahoma Arthritis Center Full time

    Job DescriptionJob DescriptionSalary: Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status. Job Summary: Reviews billing data from medical office records to ensure amounts...

  • Infusion Billing Specialist

    1 month ago

    Edmond, United States Oklahoma Arthritis Center Full time

    Job DescriptionJob DescriptionSalary: Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status.Job Summary: Reviews billing data from medical office records to ensure amounts...

  • Procurement Specialist

    4 days ago

    Edmond, Oklahoma, United States Oklahoma Gas and Electric Company Full time

    Position Overview:The Procurement Specialist is responsible for acquiring materials, equipment, supplies, and services in alignment with the organization's policies and procedures. This role involves reviewing and analyzing purchase requests, identifying and developing supplier sources, preparing bid specifications, issuing requests for bids, and evaluating...

  • Aviation Procurement Specialist

    4 days ago

    Edmond, Oklahoma, United States IAP Worldwide Services, Inc. Full time

    Job OverviewThis position is dependent on contract award.The Aviation Procurement Specialist is responsible for acquiring aviation-related products, services, materials, equipment, and supplies as required to support various operational sectors within the organization. This role involves expediting orders and ensuring timely delivery through effective...

  • Medical Customer Service

    3 weeks ago

    Edmond, United States Convatec Group PLC Full time

    Customer Care includes post-sale technical and/or non-technical customer service and support across multiple sub-families for business and/or end-consumer customers including: Remote Customer Service: Providing customer service and support via phone, online chat, or text including: •Call center-based customer support in response to a high volume of low...

  • Aviation Procurement Specialist

    4 days ago

    Edmond, Oklahoma, United States IAP Worldwide Services, Inc. Full time

    Job OverviewThis position is dependent on contract award.The Aviation Procurement Specialist is responsible for acquiring aviation-related products, services, materials, equipment, and supplies as required to support various operational sectors within the organization. This role involves expediting orders and ensuring timely delivery through effective...

  • Patient Access Specialist

    4 weeks ago

    Edmond, United States INTEGRIS Health Full time

    Job DescriptionINTEGRIS Health, Oklahoma's largest not-for-profit health system has a great opportunity for a Patient Access Specialist in Oklahoma City, OK. In this position, you'll work Monday - Friday from 8am - 4:30pm with our Patient Registration team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If...

  • Safety and Security Specialist

    4 days ago

    Edmond, Oklahoma, United States NANA Regional Corp Full time

    Job OverviewThe On-Call Safety and Security Specialist is responsible for delivering essential services to maintain a secure and safe atmosphere for various site collections, properties, facilities, visitors, and staff, all while providing exceptional customer service. This role operates within a public setting, ensuring the safety of all individuals...

  • Patient Access Specialist

    2 weeks ago

    Edmond, United States INTEGRIS Health Full time

    Job DescriptionINTEGRIS Health, Oklahoma's largest not-for-profit health system has a great opportunity for a Patient Access Specialist in Oklahoma City, OK. In this position, you'll work with our Patient Registration Team team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering...

  • Patient Access Specialist

    2 weeks ago

    Edmond, United States INTEGRIS Health Full time

    Job DescriptionINTEGRIS Health, Oklahoma's largest not-for-profit health system has a great opportunity for a Patient Access Specialist in Oklahoma City, OK. In this position, you'll work our Patient Registration team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people...

  • Auto Appraiser OKC

    7 days ago

    Edmond, United States Oklahoma Farm Bureau Insurance Full time

    Reports To: Claims Adjuster's Manager Location: OKC, OK Pay Rate:$50000 salaried plus company vehicle Primary Purpose: Obtains all necessary information to evaluate auto total loss claims and expedite settlement. Essential Duties and Responsibilities include the following. Other duties may be assigned. 1. Confirm coverage for claims. Responsible for the...

  • Project Specialist

    2 weeks ago

    Edmond, Oklahoma, United States tapwage Full time

    Position Classification:Regular, full-time, salaried, exempt, and benefit-eligible staff position. For more benefit information visit [Why Work at UCO?])General Schedule:Position typically works Monday-Friday from 8am-5pmPosition Overview and Job Duties:Coordinates the activities of a program that meet the needs of the organization's target population and...

Claims Resolution Specialist

2 months ago

Edmond, United States Variety Care Full time
Department : Billing

Position : Claims Resolution Specialist

Employee Category : Non-Exempt

Reporting Relationship : Manager of Revenue Cycle Management

Character First qualities:
  • Decisiveness- The ability to recognize key factors and finalize difficult decisions.
  • Dependability- Fulfilling what I consented to do, even if it means unexpected sacrifice
  • Initiative - Recognizing and doing what needs to be done before I am asked to do it.
  • Thoroughness - Knowing what factors will diminish the effectiveness of my work or words, if neglected.
  • Flexibility - Willingness to change plans or ideas without getting upset.


Summary of Duties and Responsibilities:

The Bilingual Claims Resolution Specialist will be responsible for working directly with patients and third-party payers to effectively resolve all unpaid claims. The primary focus is to maximize revenue for the organization and consistently work to improve the overall health of the Accounts Receivable (AR).

Primary Duties and Responsibilities :

Works collaboratively with the Senior Claims Resolution Specialist and the Manager of Revenue Cycle Management to determine the focus of collection efforts after running the weekly AR report. Contacts third-party payers about outstanding balances and provide requested documentation to achieve resolution. Contacts patients with outstanding balances to obtain payment or set up payment plan. Sends patient statements and collection letters on past due balances. Tracks and follow-up monthly on payment plans to ensure compliance. Performs write-offs, adjustments, and refunds as directed. Works closely with the Billing team to initiate and respond to billing inquiries, requests for additional information, and outstanding balance resolution. Answers patient calls and billing questions. Processes medical records requests for payers from attorneys. Assists front desk staff with patient inquiries. Assists front desk staff with obtaining correct patient addresses. Meets established daily, weekly, monthly, and annual deadlines. Manages and maintains relationships with all payors to improve patient revenue. Upholds Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information. Follows written and verbal instructions from the Manager of Revenue Cycle Management and Sr. Claims Resolution Specialist. Exhibits professionalism in communication with patients, clients, insurance companies and co-workers. Participates in special projects as assigned. Supports Variety Care's accreditation as a Patient Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable. Provides leadership and work with all staff to achieve the goals of the "Triple Aim" of healthcare reform-to improve the experience of care, improve health outcomes, and decrease healthcare costs. Embodies the strength of personal character. Places value on being an open and honest communicator who displays high moral and ethical conduct, integrity, adaptability, and sound judgment. Must be a leader in the department and community. Result-oriented problem solver who is responsible and accountable. Performs other duties as assigned.

Requirements, Special Skills or Knowledge :

High School Diploma or GED. Two years prior billing and collections experience. Working knowledge of CPT codes. Ability to read and understand Explanation of Benefits (EOB) issued by insurance carriers. Expert critical independent thinking, analytics, problem-solving and sound decision-making skills. Experience interacting and communicating effectively with individuals at various levels both inside and outside the organization, often in sensitive situations. Proficient with Microsoft Office and practice management software systems.
Preferred Requirements, Special Skills or Knowledge :
Bilingual (English/Spanish). Associate degree or equivalent combination of experience and education. Prior medical billing and insurance collections or healthcare revenue cycle experience including diversified experience with payers, managed care contracts, and payer methodology.
Essential Functions :
Must be able to lift and/or move up to 25 pounds. While performing the duties of this job, the employee is frequently required to sit, stand, walk and talk. Frequently required to bend and reach to fulfill job duties.