Medical Insurance Claims Resolution

Job DescriptionPosition: Healthcare Revenue Cycle Specialist – Insurance Claims Resolution Location: Fully remote opportunity Employment Type: Full time Direct Hire with Benefits Industry: Healthcare Revenue Cycle Management / Medical BillingOverview: We’re seeking a results-driven Healthcare Revenue Cycle Specialist with experience in EPIC systems and hospital billing to join our high-performing team. You’ll play a key role in the claims follow-up process for both hospital and physician practice clients, ensuring timely and accurate resolution of outstanding insurance claims.This is an opportunity to work in a fast-paced, high-volume environment where your problem-solving skills and healthcare billing expertise will make a direct impact on client satisfaction and company success.Key Responsibilities:Insurance Claims Follow-Up: Proactively manage and resolve outstanding insurance claims for hospital and physician clients, ensuring timely payments and accurate reimbursement.High-Volume Account Management: Work through a daily queue of 40+ accounts, maintaining attention to detail and resolution accuracy.One-Touch Resolution: Employ a “one-touch?? strategy to handle each claim as efficiently and thoroughly as possible.System Navigation: Utilize systems like EPIC, Cerner, Availity, and government payer portals to troubleshoot and resolve claim issues.Accurate Documentation: Log all interactions, outcomes, and next steps in the internal systems to ensure clear and comprehensive tracking.Cross-Team Collaboration: Work closely with billing teams, clients, and payer representatives to resolve disputes and clarify billing discrepancies.Complex Issue Resolution: Address nuanced billing problems by engaging patients, insurers, and providers as needed.Process Improvement: Offer feedback and ideas to improve internal workflows, boost efficiency, and eliminate repetitive issues.Client Relationship Management: Serve as a knowledgeable and professional point of contact for multiple clients, ensuring excellent service delivery.Retention & Quality Focus: Help achieve retention goals through reliable, high-quality claims resolution and communication.Required Qualifications:2+ years of experience in healthcare insurance claims follow-up in a hospital or large physician group setting.Proficient with EPIC and at least one other system (e.g., Cerner, Availity, payer portals).Strong understanding of commercial, Medicaid, and Medicare insurance claims processes.Excellent written and verbal communication skills.Demonstrated ability to handle high-volume workloads with accuracy.Problem-solving mindset and ability to work independently and collaboratively.Preferred Qualifications:Experience working with outsourced revenue cycle management companies.Familiarity with denial management and appeals.Knowledge of payer-specific policies and state/federal regulations related to claims processing.Why Join Us?Be part of a supportive, mission-driven team that values your contributions.Grow your healthcare revenue cycle career in a dynamic, fast-growing organization.Enjoy opportunities for process improvement, innovation, and professional development.

Created: 2025-06-03