Remote Claims Resolution Specialist na Advantia Health

Advantia is seeking a Claims Resolution Specialist to join our team! As a Claims Resolution Specialist, you will be essential in ensuring the accuracy and timeliness of billing and reimbursement for medical services. This important role demands a solid understanding of medical terminology, coding, and billing procedures. This role will report to the RCM Manager. 

Job Responsibilities: 

• Work assigned holds and worklists to effectively resolve denials, takebacks, and credits. 
• Work directly with the insurance company, the patient, and the healthcare provider to get claims processed and ultimately paid. 
• Review and appeal denied and unpaid claims. 
• Call insurance companies/payers regarding any discrepancies in payments. 
• Follow insurance guidelines and policies, and CMS guidelines and rules. 
• Perform rebill projects and additional daily reports 
• Verify patients’ insurance coverage and update claims/charts as needed. 
• Review patient bills for accuracy and completeness and obtain any missing information. 
• Answering patient inquiries regarding billing, insurance and payments as needed 
• Acting as a primary billing resource and support to practice staff. 

Job Requirements: 

• High School/GED Education required 
• Previous experience in medical billing or a related field is preferred. 
• Proficiency in electronic health records and billing software preferred. 
• Athena experience preferred. 

Please note: Advantia Health provides unparalleled healthcare to our customers by employing the most highly qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination or an approved request for accommodation is required as a condition of employment. 

Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.