Job Description
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) Apply tot his job
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