Professional Claims Resolution Specialist
20 hours ago
In this pivotal role, you will be the driving force behind delivering exceptional service to our clients. Your responsibilities will include managing and processing claims, resolving issues, and providing support while maintaining the highest standards of quality and integrity.
- Monitor outstanding insurance claims, ensuring all follow-ups are documented and communicated effectively by adding a notation to the patient's account.
- Process claims and attachments to insurance companies.
- Analyze denial validity and address them accordingly.
- Generate regular reports on claim status and ensure timely completion.
- Resubmit and reprocess claims, including grievances and appeals.
- Clear rejected claims on a weekly basis.
- Update the office tracker with all payments posted and any addressed rejected claims.
- Complete assigned follow-ups in a timely manner.
- Retrieve EOBs from insurance portals for accurate posting.
- Post insurance payments according to office preference, always uploading EOBs and applying correct adjustments.
- Identify insurance process updates and communicate findings with the team.
- Adhere to professional work ethics and schedules, ensuring timely task completion and effective communication with managers in case of attendance issues.
- Exceptional verbal and written English skills, minimal accent when speaking.
- Background in Dental insurance or collections industries.
- At least 3 years of hands-on collections experience.
- Motivated, detail-oriented, and able to work independently as this is a remote position.
- Strong organizational, time management, and follow-up skills.
- HMO with 1 free dependent upon hire (with Dental coverage).
This is an exciting opportunity to join a dynamic team and contribute your expertise to deliver top-notch service to our clients.
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