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Medical Claims Resolution Representative

MMC Billing
Warner, GA Full Time
POSTED ON 3/4/2025
AVAILABLE BEFORE 5/3/2025

JOB TITTLE: Medical Claims Resolution Representative

DEPARTMENT: Billing

REPORTS TO: Supervisor

JOB SUMMARY: Responsible for billing cycle from multiple providers in various specialties, mainly investigating, reviewing and appealing unpaid or denied claims. This position also assists in monitoring account balances from both insurances and patients.

JOB DUTIES/RESPONSIBILITIES:

  • Understands the importance of working collaboratively with both our offices and our clients to ensure an efficient workflow
  • Electronic and paper insurance claims processing, follow-up, and reprocessing if needed
  • Medical records retrieval
  • Processes turn-around documents and other tasks necessary to receive timely payment on claims
  • Verification/correction of patient demographics
  • Communicating with patients, clients, and staff
  • Assists patients and other staff with billing and insurance questions
  • Follows all HIPAA regulations to protect patient privacy and patient information
  • Substitutes for Front Office Staff as needed in all locations
  • Performs other related duties as assigned by management

SUPERVISORY RESPONSIBILITIES: This job position has no supervisory responsibilities.

QUALIFICATIONS/KNOWLEDGE/SKILLS:

  • High school Diploma or equivalent
  • Some college courses - Preferred but not required
  • Strong written and interpersonal communication skills
  • High level of accuracy and problem solving ability
  • Systems and software proficiency, including Microsoft Office
  • Ability to maintain confidentiality and exercise extreme discretion
  • Coding classes/certification - Preferred
  • Medical billing or coding experience required

STANDARD PHYSICAL DEMANDS AND WORKING CONDITIONS: The work is performed in a conventional medical office setting. It requires manual dexterity to operate keyboard and other office equipment; sitting at computer terminal for long periods of time; corrected vision and hearing to normal range; and the occasional overtime to complete tasks for accurate Month End Reports.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be taken as a complete description of all duties, responsibilities, or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Type: Full-time

Pay: $15.00 - $19.00 per hour

Benefits:

  • Paid time off

Schedule:

  • 8 hour shift
  • Monday to Friday

People with a criminal record are encouraged to apply

Work Location: In person

Salary : $15 - $19

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