Claims Resolution Specialist

Job Description

Job Description

Claims Resolutions Specialist LHH Recruitment Solutions is looking for a Claims Resolution Specialist for a client in Cincinnati, Ohio. This position is 100% onsite, temp to hire, and will pay between $18 and $21 / hr. Duties and Responsibilities :

• Coordinates workflow related to resolving outstanding medical accounts receivable, rejected / pending claims, daily correspondence, and interpreting EOB denials
• Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies
• Daily interactions with insurance carriers via web portals, telephone, scan / fax including Appeal writing and sending supporting Medical Report with physician order to resolve file rejections, and denials.
• Respond to inquiries from insurance companies, patients and providers.
• Maintains A / R averages and goals within the key performance indicators set for the Billing Claims Resolution Rep. : days in accounts receivable, percentage of net collection, percentage of non-contractual write offs, percentage of A / R over 120, the overall insurance collections for all sites assigned.
• Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.
• Acts as a resource to Supervisors, Sr. Manager, COO and other staff to accurately respond to questions / issues pertaining to billing / coding (CPT-4, HCPCS, LCD / LMRP and ICD-9 / 10).
• Ensures that all work is completed within established timeframes and in accordance with all applicable local, state and federal guidelines.
• Work Task Manager queues according to documented procedures
• Identify and escalate priority issues to the appropriate manager(s)
• Responsible for notifying by email either Sr. Billing Manager, Claims Resolution lead of any new and / or handling process required different than what's documented in your Billing Manual.

Required Qualifications Education :

Experience :

Knowledge, Skills, and Abilities :

If you are interested in learning more, please apply now.

Pay Details : $18.00 to $21.00 per hour

Search managed by : Christopher Riley

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer / Veterans / Disabled

Military connected talent encouraged to apply

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https : / / www- uat.lhh.com / us / en / candidate -privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and / or security clearance requirements, including, as applicable :

Massachusetts Candidates Only : It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.