Centralized Claims Resolution Specialist

2 weeks ago


Birmingham AL, United States Guidehouse Full time

Job Family :
Patient Account Specialist

Travel Required :

The Centralized Claims Resolution Specialist performs comprehensive account evaluations to identify the necessary steps to address outstanding account balances.

  • UB04's and 1500 Claim Files
  • Medical Record Management
  • Initiating outbound communications with Insurance Providers to address claim denials and outstanding balances.
  • Supporting Supervisory and Managerial staff with various initiatives as required.
  • Resubmitting Corrected Claims along with necessary documentation to enhance the patient experience.
  • Collaborating with other departments within the organization to ensure effective management of patient accounts.

Requirements include:

  • 6 months to 2 years of experience in healthcare claims processing
  • Proficiency in Microsoft Word and Excel
  • Basic computer literacy
  • Ability to execute essential job responsibilities with a high level of independence, adaptability, and innovative problem-solving skills.
  • Capability to interpret and apply reimbursement elements of managed healthcare agreements.
  • Outstanding customer service abilities, including efficient problem-solving and analytical skills.
  • Capacity to initiate and complete projects while working independently with minimal oversight.

Guidehouse offers a comprehensive total rewards package that includes competitive compensation and a flexible benefits package, reflecting our commitment to fostering a diverse and supportive workplace.

  • Medical, Rx, Dental & Vision Insurance
  • Personal and Family Sick Leave & Company Paid Holidays
  • 401(k) Retirement Savings Plan
  • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
  • Short-Term & Long-Term Disability Coverage
  • Tuition Reimbursement, Personal Development & Learning Opportunities
  • Corporate Sponsored Events & Community Engagement

All qualified candidates will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

If you require an accommodation during the application process, please reach out to the Guidehouse Recruiting team. All information provided will be kept confidential and used solely to the extent necessary to provide the required reasonable accommodation.



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