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Insurance Claims Resolution Specialist

2 months ago

Augusta, Maine, United States Wellstar Health Systems Full time
Company: Wellstar Health Systems

Position Overview:
The Insurance Claims Resolution Specialist plays a crucial role in the efficient management of outstanding insurance claims. This position is tasked with gathering essential information from diverse sources to ensure effective follow-up on medical claims.

The Specialist will utilize payer websites and engage in communication via telephone to ascertain the current status of pending claims, meticulously documenting all findings in the appropriate systems.

Key Responsibilities:
  • Timely and accurate resolution of open insurance claims.
  • Engagement with various stakeholders to gather necessary information.
  • Utilization of payer resources for claim status verification.
  • Documentation of claim status and follow-up actions in the system.
Position Requirements:

High School Diploma or GED with a minimum of 1 year of experience in patient accounting or billing within a healthcare setting. Exceptional phone etiquette and strong customer service skills are essential. Candidates must possess the ability to type efficiently, follow instructions, and complete assigned tasks within designated timeframes. A demonstrated capability to encourage prompt payment from managed care organizations is also required.


Category: Claims Resolution Representative