Claims Resolution Specialist
1 month ago
Salary: $55,000 - $65,000 per annum
Company Overview:Visaya KPO is a leading provider of business process outsourcing solutions.
About the Role:The Claims Resolution Specialist - Insurance Expert will play a critical role in reviewing accounts, identifying insurance overpayments and credit balances, as well as evaluating and verifying refunds are issued in accordance with current policies and procedures.
Key Responsibilities:- Review refund and overpayment requests from insurance payers to determine if overpayment has occurred.
- Review and resolve credit balances through credit transfers, account corrections, and refund request form completion for manual refund check requests.
- Identify root causes and trends contributing to patient and insurance credit balances.
- Proactively work with other revenue cycle departments to improve efficiency and reduce and/or eliminate refund issues.
- Post debits for approved refunds.
- Research returned checks and collaborate with A/P for reporting to unclaimed property.
- Resolve Department credit balance inquiries for transfers and refund check requests.
- Ability to work collaboratively and build positive business relationships with clinical areas and the payer community.
- Develop and maintain expertise with payer specialty-specific payment policies.
- Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.
- Perform special projects as required.
- A competitive salary range of $55,000 - $65,000 per annum.
- A comprehensive benefits package including medical, dental, and vision coverage.
- Opportunities for career growth and professional development.
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