Medical Claims Resolution Specialist
hace 21 horas
Job Summary
The Medical Claims Resolution Specialist will be responsible for reviewing prebill accounts that do not have an authorization on file, identifying discrepancies and communicating with third-party payors to resolve issues prior to billing. The specialist will accurately document all communications and actions taken on the account in accordance with policies and procedures.
Responsibilities
- Work prebill accounts efficiently and effectively to resolve accounts with 'no auth numbers' and ALOS vs. authorized days variances
- Report insurance denial trends identified during daily operational assignments
- Identify problem accounts and escalate as appropriate
- Contact facilities, physicians' offices, and/or insurance companies to resolve denials/appeals
- Adhere to time and attendance policies, all policies and procedures, and participate in ongoing education and training as needed
- Establish and maintain relationships with all customers
Skills and Qualifications
To be successful in this role, you should possess a high school diploma and at least one year of related experience. Key skills include:
- Effective communication and interpersonal skills
- Ability to work in a fast-paced environment and manage multiple tasks simultaneously
- Strong analytical and problem-solving skills
- Attention to detail and ability to perform basic mathematical calculations
- Knowledge of organizational policies, procedures, and systems
Benefits and Opportunities
Auxis offers a dynamic and supportive work environment, with opportunities for growth and development. If you are a motivated and detail-oriented individual with a passion for medical claims resolution, we encourage you to apply for this exciting opportunity.
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