Account Resolution Specialist - Insurance Claims
MLee Healthcare Staffing and Recruiting, Inc, Claflin, KS, United States
Account Resolution Specialist - Insurance Claims
Join a dedicated team focused on managing insurance claims and patient account resolutions in a supportive healthcare environment located in the Central Plains region of the United States. This role involves following up with insurance payers to resolve claims, processing account correspondence, and documenting all actions taken on patient accounts.
Key Responsibilities
Understand payer contracts, member co-pay, and eligibility requirements.
Respond to denials from payers related to diagnosis codes, procedure codes, contractual arrangements, and medical necessity to ensure proper payment processing.
Communicate issues or changes in payer requirements to management and analyze repetitive denials for corrective action.
Handle patient inquiries via phone and walk-ins professionally and promptly.
Resolve credit balances and maintain accurate documentation in the patient accounting system.
Meet productivity standards while adhering to privacy and security regulations concerning Protected Health Information (PHI).
Education and Experience
High school diploma or GED required.
Recent experience with third-party payers, including insurance follow-up in a medical setting.
Hospital-based patient accounting experience is preferred.
Skills and Requirements
Strong mathematical and compositional skills.
Basic computer proficiency.
Excellent communication and customer service skills with a focus on problem resolution.
Proven ability in collections and managing complex projects.
Integrity, compassion, accountability, respect, and excellence in all interactions.
Ability to work independently and adapt to changing priorities.
This position offers a competitive salary and benefits package, along with the opportunity to contribute meaningfully to a healthcare organization serving a broad regional community.
Join a dedicated team focused on managing insurance claims and patient account resolutions in a supportive healthcare environment located in the Central Plains region of the United States. This role involves following up with insurance payers to resolve claims, processing account correspondence, and documenting all actions taken on patient accounts.
Key Responsibilities
Understand payer contracts, member co-pay, and eligibility requirements.
Respond to denials from payers related to diagnosis codes, procedure codes, contractual arrangements, and medical necessity to ensure proper payment processing.
Communicate issues or changes in payer requirements to management and analyze repetitive denials for corrective action.
Handle patient inquiries via phone and walk-ins professionally and promptly.
Resolve credit balances and maintain accurate documentation in the patient accounting system.
Meet productivity standards while adhering to privacy and security regulations concerning Protected Health Information (PHI).
Education and Experience
High school diploma or GED required.
Recent experience with third-party payers, including insurance follow-up in a medical setting.
Hospital-based patient accounting experience is preferred.
Skills and Requirements
Strong mathematical and compositional skills.
Basic computer proficiency.
Excellent communication and customer service skills with a focus on problem resolution.
Proven ability in collections and managing complex projects.
Integrity, compassion, accountability, respect, and excellence in all interactions.
Ability to work independently and adapt to changing priorities.
This position offers a competitive salary and benefits package, along with the opportunity to contribute meaningfully to a healthcare organization serving a broad regional community.