Medical Claims Resolution Specialist

Advantage Resourcing is excited to offer a fantastic opportunity for a Medical Claims Resolution Specialist to join a dynamic team providing exceptional home healthcare services, with a focus on respiratory care. Our client is a leading provider of home disease management, dedicated to delivering personalized care right in the comfort of patients' homes. If you're detail-oriented, organized, a strong communicator, and proficient in Microsoft Office, we want to hear from you!

$18/hr.

Shift: Monday-Friday, 8:00 AM - 5:00 PM

In this role, you will review and interpret insurance policies and Explanation of Benefits (EOBs), analyze medical documentation, and resolve back collections, including tasks such as denial appeals, payment reviews, balance billing, and claims generation. You'll also maintain clear and effective communication with insurance carriers, patients/families, and internal teams to ensure the best outcomes for patients. Additionally, you will handle clerical tasks like answering patient/insurance calls, faxing, and emailing, while also escalating concerns to the Revenue Cycle Manager as needed. Other responsibilities and projects may be assigned as necessary.

Qualifications:

• High School Diploma or equivalent
• Knowledge of insurance Explanation of Benefits (EOBs) and Medicare/Medicaid billing regulations
• Familiarity with CPT/ICD-10 codes, HCFA 1500, UB04 claim forms, and HIPAA
• 1 year of insurance verification or authorizations experience
• 3-5 years of DME or medical billing experience preferred
• Proficient in Microsoft Office (Outlook, Word, Excel)
• Strong organizational and communication skills
• Attention to detail and ability to maintain accuracy

What We Offer:

• Payday every Friday via direct deposit or pay card
• Support from a dedicated local team that cares about your success
• Employee discounts and referral bonus opportunities
• Comprehensive benefits including medical, dental, vision, and 401K options
• A rewarding career with plenty of growth potential

Ready to make a difference in healthcare and start a rewarding career? Click "Apply Now" to join our team and begin this exciting journey with us. We can't wait to connect with you!

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Advantage Resourcing is committed to providing equal employment opportunity for all persons regardless of race, color, religion (including religious dress and grooming practices), sex, sexual orientation, gender, gender identity, gender expression, age, marital status, national origin, ancestry, citizenship status, pregnancy, medical condition, genetic information, mental and physical disability, political affiliation, union membership, status as a parent, military or veteran status or other non-merit based factors. We will provide reasonable accommodations throughout the application, interviewing and employment process. If you require a reasonable accommodation, contact your local branch. Advantage Resourcing is an E-Verify employer. This policy is applicable to all phases of the employment relationship, including hiring, transfers, promotions, training, terminations, working conditions, compensation, benefits, and other terms and conditions of employment.

All employees are directed to familiarize themselves with this policy and to act in accordance with it. All decisions with respect to employment matters and other phases of employer-temporary employee relationships will be in keeping with this policy and in accordance with all applicable laws and regulations.