Claims Resolution Specialist

Job Summary

A company is looking for a Claims Resolution Specialist I.

Key Responsibilities

• Review medical insurance claims for resolution and payment
• Resolve inquiries or payment denials from insurance providers and respond to documentation requests
• Contact insurance carriers to collect on open account balances

Required Qualifications

• Excellent knowledge of insurance carrier billing and reimbursement, including medical terminology, ICD-9, and CPT codes
• In-depth understanding of explanation of benefits (EOB)
• At least one year of prior medical billing or medical collections experience
• Experience with EMR or GE Centricity Practice Management software preferred
• Experience in Medical Oncology, Radiology, Radiation, Laboratory, or Pathology preferred