
Insurance Claim Analyst and Denial Resolution Specialist
1 day ago
ClinicMind is seeking a highly motivated Medical Claims Resolution Specialist to join their team. As a Medical Claims Resolution Specialist, you will be responsible for resolving claim denials, underpayments, and delays in insurance reimbursement for healthcare practice owners.
Key Responsibilities:
- Maximize insurance reimbursement by resolving claim denials, underpayments, and delays.
- Interact with US-based insurance carriers to follow up on unpaid claims, delayed processing, and underpayment.
- Plan and execute medical insurance claim denial appeal process to ensure timely resolution.
- Collaborate with practice owners and clinicians to correct missing or incorrect data on their insurance claims.
Required Skills and Qualifications:
- At least 6 months of experience in US-based AR follow-up and charge payment posting.
- Familiarity with the US medical insurance industry and insurance claims processing cycle.
- Knowledge of ICD-10, CPT, and HCPC coding systems.
- Understanding of CMS-1500 and UB-04 claim formats.
- Proficiency in Vericle Software is mandatory.
- Excellent listening, communication, and problem-solving skills.
- Self-motivated and able to work autonomously.
Benefits:
- Full-time remote work arrangement.
Additional Information:
- High comfort level working on Eastern Time Zone/US Shift.
- Good internet access at home.
- Mobile Hotspot.
- Laptop/Desktop with at least 8 GB RAM.
Seniority Level:
- Entry-level position.
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