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Claims Resolution Specialist
2 months ago
Follows-up on all claims that have been billed out in a timely and effective manner.
Work all claims to a zero balance resolution through a compilation of options such as interacting
with the payer directly, using the payer portal, formally appealing, and/or consideration for appropriate adjustment.Verifies all charges on claims are accurate with correct charge amounts including billing correct
units.Verifies all patient and insurance information on claims to ensure it is accurate.
Understands and stays up to date with contractual rates and billing practices
Applies critical thinking skills to resolve a claim utilizing appropriate methods by which to interact
with the payer through specific process and/or technological tools.Considers the value of seeking medical necessity review , coding review, or charge review depending
on claim denial issue and collaborates with other departments following established processes.Reports to leadership any trends that are being seen with claim denials or billing errors.
Helps identify follow-up issues to find root cause of denial.
Comprehends and can trouble shoot claim issues as the specialist work queue is built by rules
of exception.
3-5 Must Have Skills/Qualifications:
- Physician billing experience
- EPIC EMR experience
- Commercial & Government experience
- Appeals & Claims Follow up experience
- payor guidelines
Nice to Have Skills:
- Surgical billing
- Cancer facility background
Schedule: Full time Monday through Friday (Flexible start time 6:00am-8:30am after training)
Equipment: Provided
Can only be remote out of the following states:
- AL
- FL
- GA
- ID
- IN
- KY
- LA
- MI
- NC
- OH
- OK
- OR
- SC
- SD
- TN
- TX
- VA
- WV
- WY
Metrics: 20-25 accounts per day
Training: Monday-Friday mirroring others, then EPIC training
Company DescriptionHere at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?Company DescriptionHere at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r
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Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?