Medical Claims Payment Resolution Specialist
Location: Royal Oak
Posted on: January 8, 2022
Our Health Care client in Royal Oak, MI needs to hire a Medical
CLAIMS PAYMENT RESOLUTION SPECIALIST (BILLING) that is talented in
getting claims resolved and paid. Seeking an individual with a
positive track record that enjoys this type of work.
Work in a shared services environment supporting a specific client
POSITION TYPE: Full Time. Direct Hire. Ability to work hybrid
schedule after training period is complete.
PAY: $38,000 to $48,000 Annual (depending on experience) plus
benefits package and paid time off.
--- Follow up on claims that have already been submitted for
payment by the claims entry team and that either are denied or
rejected by insurance companies.
--- Follow documentation to understand specific reason for denial
of payment. Provide information that is incomplete or incorrect. Be
aware of patient's diagnosis and specific coding relative to that
diagnosis that is billable/collectible.
--- Support assigned clinics by conducting practice reviews and
analysis. Obtain information relative to patient's
condition/diagnosis/coding that applies to rejected billing to
--- Document and follow-up entries on patient accounts.
--- Operate medical billing software programs.
--- Use strategy and tact with insurance companies to resolve
--- Effectively communicate patient and clinical issues
--- Work to reduce then maintain 10% or less 120+ receivables
--- Working denials and rejections in a timely manner providing a
follow up within 48 hours.
--- Represent multiple practices in a professional and positive
--- Effectively communicate with staff and management.
EDUCATION AND EXPERIENCE
--- High School diploma. Any additional health care education a
--- 3 years previous health care claims processing experience.
--- Minimum 2 years work experience handling rejected and/or denied
claims collection activities. Ability to problem solve and escalate
issues as appropriate.
--- Experience with Internal Medicine/Family Practice, Pain
Management, Oncology, or Addiction Medicine areas of treatment a
--- Ability to navigate Insurance company websites to submit and
query claims is required.
--- Experience with IVR -Integrated Voice Response required.
(Navigating phone options to obtain info from Insurance
--- Ability to pass a background check and drug screen.
--- Must be fully vaccinated prior to start (Mandated due to health
Keywords: Venteon, Royal Oak , Medical Claims Payment Resolution Specialist, Healthcare , Royal Oak, Michigan
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