Claims Resolution Specialist

Location: Remote
Compensation: Hourly
Reviewed: Fri, Mar 14, 2025
This job expires in: 29 days

Job Summary

A company is looking for a Claims Resolution Specialist- Remote.

Key Responsibilities
  • Validate denial reasons and ensure accurate coding in the DCM system
  • Generate appeals based on dispute reasons and payer guidelines
  • Research contract terms and compile documentation for appeals
Required Qualifications, Training, and Education
  • High School Diploma or equivalent; some college coursework preferred
  • 3 - 5 years experience in a hospital business environment, focusing on billing and/or collections
  • Intermediate understanding of EOB forms, managed care contracts, and hospital billing requirements
  • Intermediate knowledge of ICD-9, HCPCS/CPT coding, and medical terminology
  • Intermediate Microsoft Office skills

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