
Claims Resolution Professional
1 day ago
Job Summary: We are seeking a detail-oriented Medical Claims Specialist to support the revenue cycle operations of our healthcare client. This role is primarily focused on reducing claim denials and recovering aging or stale claims.
This is an ideal opportunity for someone with experience in medical billing or claims follow-up who thrives in a fast-paced, process-driven environment.
- Log into the clients billing system to review and manage denied or aging claims
- Work claim queues to identify root causes of denials and submit appropriate documentation or corrections
- Make outbound phone calls to insurance payers to check claim statuses, appeal denials, and resolve payment issues
- Escalate recurring denial trends or system/process bottlenecks to the clients RCM lead
- Maintain accurate and detailed notes of all payer interactions and claim activities
- Assist with additional RCM workflows as needed to support clean and efficient revenue operations
- 1-3 years of experience in medical billing, revenue cycle management, or claims follow-up
- Familiarity with payer portals and billing systems (e.g., Kareo, Athena, AdvancedMD, etc.)
- High attention to detail and ability to work independently on repetitive or process-heavy tasks
- Strong written and verbal communication skills in English
- Comfortable speaking with payers over the phone and navigating insurance systems
- Experience with denial management and recovery of aged claims
- Previous work with U.S.-based healthcare providers
- Background in a remote RCM role
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