Claims Resolution Specialist

5 days ago


Houston, Texas, United States Medical AR Management Services, LLC Full time

Company Overview

Medical AR Management Services, LLC is a dynamic organization dedicated to delivering exceptional medical accounts receivable management solutions.

Job Summary

We are seeking an experienced Error Processing Specialist to join our team. The successful candidate will be responsible for resolving front-end and back-end errors related to claims rejected by billing clearing houses or insurance carriers.

About the Role

This challenging position requires strong analytical and problem-solving skills, as well as excellent communication and organizational abilities. The ideal candidate will have experience working in healthcare settings, with a focus on clearinghouse error processing and resolution functions.

Key Responsibilities

• Resolve data discrepancies and update relevant systems
• Perform quality insurance coverage and eligibility verification
• Collaborate with team members to ensure data accuracy and integrity
• Maintain accurate records and reports
• Stay up-to-date with Federal, state, and HIPAA regulations

Requirements

• High school diploma or equivalent
• 2+ years' experience in healthcare setting
• 2+ year experience performing clearinghouse error processing and resolution functions
• Strong computer skills in Microsoft Windows environment
• Excellent typing speed (10,500 KSPH) and accuracy (95%+) required
• Strong cognitive skills, including analysis, problem-solving, and decision-making
• Ability to work collaboratively and maintain confidentiality

Preferred Qualifications

• Clinical and/or Anatomic Pathology accounts receivable experience
• Familiarity with XIFIN, Health Pac software, and Waystar/ZirMed clearinghouse experience a plus
• Knowledge of online payer portals, such as Palmetto, Availity, TMHP, UHC Link, and Navinet

Competencies

• Organizational: ability to operate effectively within standard operating procedures, demonstrate effective verbal, written, and listening skills, and strive to meet and exceed expectations.
• Problem-Solving: identifies and resolves problems in a timely manner, gathers and analyzes information skillfully, develops alternative solutions, and works well in group problem-solving situations.
• Judgement: displays willingness to make decisions, exhibits sound and accurate judgment, supports and explains reasoning behind decisions.
• Professionalism: approaches others in a tactful manner, reacts well under pressure, treats others with respect and consideration, accepts responsibility for own actions, and follows through on commitments.

Salary

$60,000 - $80,000 per annum, depending on experience



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