Claims Resolution Specialist - Carrier Relations

Job Description

Job Description

We are #Hiring! Join Medlytix , a fast growing healthcare consulting and technology company specializing in predictive analytics for revenue cycles and collections in leading hospitals and healthcare providers. Utilizing sophisticated data mining and scoring strategies, we have successfully enhanced revenue cycles and collections nationwide.

Description :

The Claims Resolution Specialist plays a key role in resolving open receivables for our clients.

You will process medical (physician and hospital) bills that involve motor vehicle accidents, workers' comp, and third-party claims. The Claims Resolution Specialist will work toward increased reimbursement and account resolution.

Responsibilities :

• Provide exceptional customer service for inbound calls.
• Interface with insurance agents, patients, and others to the disposition of each account.
• Identify obstacles to claim submission and payment, including updating insurances, adjuster contact information, submitting bills, and providing requested documentation.
• Identify patterns with payers that result in non-payment or delayed payment. Ability to summarize and escalate in the correct manner.
• Update accounts in our proprietary technology platform to increase probability of collection and resolution of accounts.
• Rely on experience and judgment as well as instructions and pre-established guidelines to plan and accomplish goals and perform a wide variety of tasks.

Required Skills :

Education and Experience :

As part of our commitment to quality and excellence, Medlytix will continue to maintain a safe and healthy environment for you by requiring all applicants to submit to a criminal history check and those tentatively selected for a position to submit to screening for illegal drug use prior to appointment for a job. In addition, applicants may be screened for ability to perform essential functions of some positions.