Clm Resltion Rep III, Hosp/Prv
Core
Resolves complex medical claims and accounts receivable to ensure maximum revenue collection for the hospital.
Role type
Senior claims resolution representative (medical billing)
Builds
Closed accounts receivable and resolved insurance claims
Domain
Healthcare / Medical Billing
Required skills
Claims adjudication, Insurance coverage verification, Medicaid/Medicare billing, Account reconciliation, Payer correspondence, Audit support
Preferred skills
Experience with electronic health records, Knowledge of payer trends
Technologies
Electronic health record systems
Responsibilities
Researches, corrects, and resubmits denied or unpaid claims; contacts payer representatives to resolve payment issues; bills primary and secondary insurance claims; identifies and clarifies billing variances; coordinates responses to Medicaid and Medicare credit balances; enters documentation into electronic health records; assists with audits and reviews credit balances.
Seniority
Mid-level, individual contributor