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
COMPLETE JOB DESCRIPTION
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