Insurance Account Resolution Specialist
Australia, Canada, New Zealand, United Kingdom, United StatesFull-Time
Salary not disclosed
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Job Details
- Required Skills
- Analytical SkillsMicrosoft ExcelDocumentation
Requirements
- High School Diploma or equivalent.
- Proficiency in Microsoft Outlook, Word, and Excel.
- Ability to type at least 40 WPM with accuracy.
- Proven ability to handle high-volume workloads and meet deadlines.
- Experience in a structured environment with performance metrics or call monitoring.
- Strong verbal communication skills for professional interactions with carriers.
- Excellent written communication skills for documentation and correspondence.
- Exceptional attention to detail in reviewing claims and identifying discrepancies.
- Ability to work independently and manage goals in a remote environment.
- Dependable, punctual, and accountable.
Responsibilities
- Research and resolve pending, denied, or incorrectly paid claims with commercial insurance carriers.
- Investigate claims on hold to identify root causes and execute corrective follow-up actions.
- Analyze denials to determine validity and prepare appeals, corrections, or resubmissions.
- Communicate directly with insurance carriers via phone to clarify discrepancies and secure claim status.
- Submit required documentation and EOBs to support claim adjudication.
- Maintain detailed documentation of follow-up activities in billing systems.
- Identify and escalate recurring issues or trends to support process improvements.
- Meet daily productivity and accuracy performance metrics.
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