Claims Resolution Specialist

Job Description

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 required.

RESPONSIBILITIES

• Initiating ERA (electronic remittance advice) set up with clearinghouse and/or third-party portals.
• Initiating EFT (electronic funds transfer) set up with payers & third-party portals.
• Assist in vendor support of daily cash reconciliation duties.
• Clear understanding of RCM Payment Posting Processing (ERA/Manual Posting) of Line-Item Payments/Denials.
• Clear understanding of reconciling offset/recoupment payer remits.
• Call carriers and third parties to resolve unidentified payments/reconcile items.
• Responsible for maintaining payer portal admin and employee registration.
• Assist the RCM Manager with various projects.

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