Medical Claims Resolution Specialist

Greenville, NC 27834

Posted: 06/07/2024 Employment Type: Temporary Industry: Outreach/Behavioral Health Job Number: 321 Pay Rate: $16.00

Job Description

Remote Claims Resolution Specialist (Contract)

Do you have a passion for problem-solving and supporting healthcare providers?

We are seeking a highly organized and detail-oriented individual to join an established behavioral health agency as a remote Claims Resolution Specialist (Contract). In this role, you will be the  point of contact regarding claim issues, providing exceptional support and ensuring a smooth claims experience.

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 (preferred).
  • 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. 

Additional Information

Benefits:

  • Remote position.
  • Opportunity to contribute to a growing and dynamic organization.
  • Work in a mission-driven environment, supporting access to quality mental healthcare.

 

#claims #claimresolution #claimresearch

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