Claims Resolution Coordinator Job at Remote in Remote
Our Claims Resolution Coordinators investigate and analyze accounts in order to properly identify and coordinate insurance benefits and resolve outstanding balances. Works closely with the patient as well as insurance carriers until the claim has reprocessed and payment has been issued.
PRIMARY DUTIES AND RESPONSIBILITIES MAY INCLUDE ANY OR ALL OF THE FOLLOWING:
Perform daily tasks presented by manager such as account work, special projects, or requests
Reach daily/monthly quota and/or goals
Conduct online medical research using multiple online medical websites
Contact patients by either phone or through letters
Review medical records, provider notes, Explanation of Benefits, etc. for knowledge of appeal or account information
Update claims system with updated accurate information
Attend weekly denials meeting to discuss updates/changes such as new hospital procedures or current client issues
Communicate any issues through the manager including, but not limited to, PTS errors, questions for other departments, HIPAA questions
Stay up to date on state laws governing fee schedules, filling limits, and other statutes.
Participate in special projects when presented by management or Partners
Comply with company’s code of conduct.
Additional duties and responsibilities as assigned.
Office environment with some exposure to external environment, temperature changes, uneven walking services.
Talking: Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly.
Hearing: Able to hear average or normal conversations and receive ordinary information.
Repetitive motion: Frequent and regular use of the wrists, hands, and fingers to make small movements such as typing or picking up small objects. Normal fine and gross motor control of fingers and hands.
Seeing: Visual acuteness necessary for the proper evaluation of or to prepare, inspect documents or other materials. Ability to accurately view computer monitors.
Physical: Frequent sitting, standing and walking. Occasional lifting up to 25 lbs, pushing and pulling up to 45 lbs. Occasional kneeling, stooping, and bending at the waist.
POSITION QUALIFICATIONS AND REQUIREMENTS:
Bachelor’s degree is preferred or comparable work experience or work experience and education
Prior experience with insurance claims and/or a background in the legal profession is preferred but not required
Prior experience in an administrative or clerical role in an office environment preferred
Knowledge, Skills, Abilities and Competencies:
Minimum 45 WPM Typing and 6,000 KPH 10-key
Consistent ability to work with a high volume of accounts
Focused and self-motivated
Excellent investigative and problem-solving abilities
Close attention to detail and accuracy
Ability to learn software systems
Exceptional organization, time management, prioritization skills
Ability to adapt to constantly changing environment/ well developed multitasking skills
Exceptional written and verbal communication skills including grammar
Ability to contribute in a positive manner
Proficient using Microsoft office products such as Word, Excel, Outlook and Adobe Acrobat
Knowledge of Healthcare Terminology preferred but not required
Company Location: Remote