Claims Resolution Specialist

Job Type

Full-time

Description

Zinnia Health is a fast-growing integrated healthcare company. We value our employees and care for our clients. Do you have unique talents that you would like to share with others? We would love to have you join our team!
? Competitive Pay
? Career Development
? Tuition/Education Reimbursement
? Competitive Benefits & 401k
? Values: Integrity, Teamplay, 1% Better Each Day

The Claims Resolution Specialist will be able to promptly follow up on the status of claims as well as resolve any issues or denials. They will be well versed in the ability to verify benefits as well as attempt an appeals process.

DUTIES AND RESPONSIBILITIES
? Follow Zinnia Health's policies and procedures.
? Ability to complete verification of benefits with health insurance plans for both in and out of network benefits.
? Following up on and providing claim status.
? Following up on and communicating actions that need to be taken to adjudicate claims, including the ability to properly correct claims.
? Updating A/R
? Managing spreadsheets for reporting and advanced ability on excel.
? Ability to well navigate in CMD and document all correspondence in CMD.
? Ability to reconcile claims in CMD and apply payments and credits to accounts.
? Types and performs data entry as needed.
? Answers phone calls and maintains professionalism with patients and insurance companies.
? Assists staff and clients with scheduling concerns or conflicts.
? Reads and routes incoming mail.
? Conducts research, and compiles and types statistical reports.
? Makes copies of correspondence or other printed materials and be able to interpret explanation of payments and benefits.
? Prepares outgoing mail and correspondence, including e-mail and faxes.
? Perform high volume of collection calls and/or correspondence in a fast paced, goal-oriented collections department.
? Ability to renegotiate claim payments and file appeals when necessary.
? Ability to recognize billing errors and correct them.
? Ability to reprocess claims for various denial reasons

MINIMUM QUALIFICATIONS
? Has a high school diploma or GED
? Previous experience working with insurance billing for facility preferred.
? Exceptional attention to detail and an eye for spotting errors and discrepancies.
? Strong communication and customer service skills with the ability to see issues through to resolution.
? Intermediate to advanced levels of skills in Microsoft Office and a proven aptitude for computers.
? Strong understanding of current ICD-10, CPT and HCPCS coding practices

Salary Description

$18 - $24 hourly

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