Job Summary
We are seeking an experienced Medical Claims Resolution Specialist to join our remote team. This role focuses on resolving complex, high-dollar unpaid or denied claims using EMR systems, payer portals, and in-depth billing knowledge. You’ll be instrumental in helping clients meet their financial goals through accuracy, efficiency, and accountability.
Key Responsibilities
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Resolve unpaid/denied medical and dental claims using internal tools, phone outreach, payer portals, and client systems
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Identify and escalate issues such as coding errors, missing charges, and revenue mapping mismatches
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Conduct patient account assessments and complete rebill functions
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Handle administrative tasks including submitting medical records, verifying payments, updating insurance information, and managing corrected claims
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Maintain familiarity with client preferences across multiple accounts
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Support special projects as assigned
Qualifications
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High School Diploma or equivalent
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5+ years of experience in healthcare billing, registration, or collections
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3+ years in insurance claims resolution
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EMR experience with systems like Dentrix, Epic, Cerner, or Meditech (preferred)
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Proficient in ADA claim forms, EOBs, EOPs, Remits, ICD-9/ICD-10, and CPT coding
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Advanced skills in Excel and PowerPoint
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Strong communication, multitasking, and problem-solving skills
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Ability to work independently in a remote environment
Physical Requirements
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Ability to sit and work at a computer for 6–8 hours daily
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Occasional lifting of materials up to 20 lbs
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Must function effectively in a fast-paced environment with interruptions
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Reasonable accommodations available for qualified individuals
About Us
Our mission is to help clients exceed their financial health goals. Through cutting-edge technology, clinical expertise, and data-driven solutions, we simplify the reimbursement cycle. We invest in long-term careers by fostering an environment of personal and professional growth—because your success is our success.
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