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Claims Resolution Specialist

2 months ago


Indianapolis, Indiana, United States Express Employment Professionals Full time
Job Overview

Position Summary:

  • Investigate Medicaid claims to reach resolution, which may involve exploring both the Medicaid framework and the Client's system.
  • Continue to research claims until full payment is secured or until the account is deemed returnable.
  • Document and track progress within both the company and Client systems.
  • Solicit necessary documentation from external sources to accurately adjudicate claims.
  • Ensure all required documentation is filed correctly.
  • Address client inquiries related to claims effectively.
  • Stay updated with trends and advancements pertinent to essential job skills.
  • Uphold the confidentiality of patient health information in accordance with HIPAA regulations.
  • Execute additional job-related responsibilities or special projects as needed.

Employment Type: Temporary to Permanent

Work Schedule: Monday – Friday, 8:00 AM - 4:30 PM

Compensation: $19 per hour

Qualifications:

  • Mandatory: High school diploma.
  • Mandatory: Strong investigative, analytical, and judgment capabilities.
  • Mandatory: Excellent spelling and grammar; proficient phone communication; basic mathematical skills; strong organizational abilities; adept at prioritizing and meeting deadlines; capable of multitasking; must meticulously proofread own work.
  • Mandatory: Effective communication skills to relay necessary information accurately, listen attentively, and ask clarifying questions when needed.
  • Preferred: Familiarity with ICD-10 and CPT coding.
  • Preferred: Experience with multi-line claims, including knowledge of UB04 and CMS1500.
  • Preferred: Understanding of the Indiana Medicaid Portal, including all Managed Care payer portals for claims correction and eligibility verification.
  • Preferred: Experience with the Cerner System.

About Express Employment Professionals:

Express Employment Professionals is dedicated to helping you find a job that aligns with your skills and preferences, without any fees for our services. Whether you seek full-time, part-time, or flexible work arrangements, we can connect you with a variety of positions across Administrative, Industrial, and Professional sectors. Explore your options with us today.

Benefits for Eligible Express Associates:

  • Referral Bonus
  • Medical/Dental/Vision Plans
  • Direct Deposit
  • 401(k) Retirement Savings Plan
  • Life Insurance
  • Short-Term Disability

For a comprehensive list of all available positions, please visit our jobs page on our website.

Application Process:

To apply, please submit your resume with the subject line 'Claims Resolution Specialist'.