Healthcare Claims Resolution Specialist

6 days ago


Tampa, Florida, United States Sherloq Solutions Full time

Company Overview

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Sherloq Solutions is a reputable company with over 100 years of history in the community. We foster a team environment, respect and value our employees' contributions.

Salary

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This position earns an estimated $60,000 - $80,000 per year, depending on experience, to maximize your skills in the healthcare revenue cycle industry.

Job Description

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We are seeking candidates with experience from healthcare providers or insurance payers who can resolve healthcare claims through verbal or online inquiries to health insurance payers.

  • Navigate and utilize various healthcare provider software systems to verify patient, insurance, billing, and claim submission information for accuracy.
  • Analyze payer denials and respond to secure claim reimbursement.
  • Track trends in payer underpayments, coding issues, and denials and report to leadership for escalation.
  • Recognize basic coding denials and request appropriate action for correction or dispute.

Required Skills and Qualifications

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To succeed in this role, you must have excellent verbal and written communication skills, be able to problem solve, think critically to identify trends, and work well with others.

A background in medical claims billing, insurance collections, coding, and/or denials management is desired. Three (3) years of healthcare industry experience preferred.

Benefits

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We offer competitive benefits, including medical insurance, a 401(k) plan, generous vacation and paid-time-off (PTO), eight paid holidays, tuition reimbursement, life, dental, accidental death & disability, and supplemental insurance.



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