Medical Claims Resolution Specialist
East Carolina Univ, NC 27834 US
Job Description
Remote - Medical Claims Resolution Specialist needed!
(Contract Based)
$16.00/hour
We are seeking a highly organized and detail-oriented individual to join an established behavioral health agency as remote Claims Resolution Specialist.
In this role, you will be the point of contact regarding claim issues, providing exceptional support and ensuring a smooth claims experience.
** Prior experience is mandatory, at least 3 years previous experience needed. **
*Position will last through June 2025*
Responsibilities:
- Review and address claim issues received via phone, email, and a ticketing system.
- Research and gather information related to claim denials and approvals.
- Communicate resolutions and summaries of claim issues clearly and concisely to providers.
- Log and track all contact with providers.
- Assist the Claims Department with additional duties as needed.
Job Requirements
Qualifications:
- Previous experience in medical claims processing, including reviewing claims, denials, and member eligibility.
- Excellent communication and interpersonal skills, both written and verbal.
- Strong analytical and problem-solving abilities.
- Ability to work independently and manage multiple tasks simultaneously.
- Proficient in Microsoft Office Suite (Word, Excel, Outlook).
- Prior experience with a claims management system is a plus.
** Candidates must live within the company's service area in North Carolina **
** Prior experience is mandatory, at least 3 years previous experience needed. **
Additional Information
Remote position.
Opportunity to contribute to a growing and dynamic organization.
Work in a mission-driven environment, supporting access to quality mental healthcare.
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