Claims Resolution Specialist

Select Medical•Camp Hill, PA

1d•Onsite

About The Position

Our dynamic team has the responsibility of resolving outstanding insurance claims so that our patients are not impacted. We offer an exceptional employee experience, full-time hours, full benefits, paid training, and advancement opportunities. Our team offers flexible, first shift, Monday through Friday schedules. This would include two fifteen-minute breaks and one half-hour lunch. We allow for casual work attire; jeans are our norm! Role involves outbound call activity on a daily basis, including reaching out to insurance companies and patients. Responsible for following up on escalated cases on high-dollar accounts, completing research, resolving outstanding issues, and providing callbacks. Handles account research and insurance inquiries, including gathering information and asking detailed questions. Candidates should expect to be on the phone consistently throughout the day, regardless of inbound call volume.

Requirements

High School Diploma or Equivalent
One year of experience (2+ years for remote candidates) within a medical billing, medical collecting or claims processing role.
Computer Skills
Microsoft Office: Outlook, Excel
Ability to work with multiple programs simultaneously.
Good interpersonal, oral and written communication skills.
Proven experience with investigative research.
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

Nice To Haves

Previous experience in metrics based role, where production/quality standards are upheld.
Time management and organizational skills
Ability to work independently and as part of team to reach mutually established goals.
Attention to detail
Flexibility and being open to change

Responsibilities

Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing. Contact responsible party to establish reason for non-payment document in system all verbal and written communication relative to open account balance, and institute timely follow-up with responsible party as a result of last contact to assure progress in resolving account with payment.
Maintain consistent, productive, and timely follow-up, as often as is needed to collect on the account. Time between account follow up is not to exceed 30 days.
Maintain a productivity of 20 to 25 accounts per day. This is subject to change based on volume changes and operational needs.
Make outgoing calls to patients, insurance companies and attorneys regarding claim status in order to reduce both outstanding receivables.
Regularly communicate with hospital staff and department management on any accounts receivable issues/problematic payor trends.
Identify and resolve issues impacting the timely collection of open receivables.
As necessary, request account adjustments as identified via write off requests and refund requests.
Notify database operations of changes or additions to specific payor, plan, contract, address, or other pertinent information as necessary.
Meet the expectations and goals for productivity and collections targets as set forth by management.
Performs other duties or special projects as assigned.