Claims Resolution Specialist

5 days ago

Washington, United States Advantia Health Full time

Claims Resolution Specialist Advantia is seeking a Claims Resolution Specialist to join our team As a Claims Resolution Specialist, you will be essential in ensuring the accuracy and timeliness of billing and reimbursement for medical services. This important role demands a solid understanding of medical terminology, coding, and billing procedures. This role will report to the RCM Manager. Job Responsibilities: Work assigned holds and worklists to effectively resolve denials, takebacks, and credits. Work directly with the insurance company, the patient, and the healthcare provider to get claims processed and ultimately paid. Review and appeal denied and unpaid claims. Call insurance companies/payers regarding any discrepancies in payments. Follow insurance guidelines and policies, and CMS guidelines and rules. Perform rebill projects and additional daily reports Verify patients' insurance coverage and update claims/charts as needed. Review patient bills for accuracy and completeness and obtain any missing information. Answering patient inquiries regarding billing, insurance and payments as needed Acting as a primary billing resource and support to practice staff. Job Requirements: High School/GED Education required Previous experience in medical billing or a related field is preferred. Proficiency in electronic health records and billing software preferred. Athena experience preferred. Please note: Advantia Health provides unparalleled healthcare to our customers by employing the most highly qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination or an approved request for accommodation is required as a condition of employment. Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.

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