Job Description:
• Handle complex claim scenarios and mentor staff
• Resolve out-of-network claims and review/write appeals
• Assist with training and provide resources for team members
• Resolve unpaid or incorrectly paid claims
• Communicate with patients, providers, coders, and other stakeholders
• Train and mentor new hires
• Review reports to identify revenue opportunities
• Maintain patient confidentiality
• Provide insight on billing processes and procedural improvements
Requirements:
• Advanced knowledge of billing systems, denial management, and payer-specific requirements
• Ability to coach, train, and mentor other team members
• Strong analytical and decision-making skills; able to handle complex accounts independently
• Ability to identify trends, propose solutions, and contribute to process improvements
• Experience writing appeals and handling escalated claim issues
• High school diploma or equivalent required. Associates degree in related field preferred
• Previous experience in a customer service or healthcare setting required
Benefits:
• Employees shall adhere to high standards of ethical conduct
• Maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA)
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