Claims Resolution Specialist

About the Role

This in-office Claims Resolution Specialist position at Select Medical involves proactively handling outstanding insurance claims to prevent any adverse impact on patients. Starting pay begins at $18.50 per hour, with potential flexibility for highly experienced candidates. Team members enjoy full-time schedules with benefits, paid training, opportunities for career growth, and a casual dress code where jeans are common. Work hours follow a first shift, Monday through Friday pattern with two 15-minute breaks and a half-hour lunch.

Key Responsibilities

• Investigate and follow up on all outstanding account balances that have received payment or denial or are more than 30 days from billing, contacting responsible parties to establish reasons for non-payment.
• Document all verbal and written communications regarding open balances timely in the system, ensuring consistent follow-ups to resolve payment issues.
• Maintain a daily workload processing 20 to 25 accounts, adjusting for volume and operational needs.
• Make outbound calls to patients, insurance companies, and legal representatives to update claim statuses and reduce receivable balances.
• Collaborate frequently with hospital staff and department managers to address accounts receivable concerns and identify problematic payer patterns.
• Identify and solve challenges that delay timely collection of open receivables and submit requests for account adjustments like write-offs or refunds as needed.
• Inform database operations promptly of any changes to payer, contract, plan, or contact details affecting claims processing.
• Achieve productivity and collection goals as established by management.
• Perform other assigned duties and special projects as needed.

Qualifications

• Required: High school diploma or equivalent.
• Minimum of one year experience in medical billing, collections, or claims processing.
• Familiarity with private and commercial claims collection processes, preferably on the provider side.
• Knowledge of Medicare and Medicaid claim procedures.

Preferred Skills

• Proficiency with Microsoft Office, particularly Outlook and Excel.
• Ability to manage multiple software programs concurrently.
• Strong interpersonal, oral, and written communication capabilities.
• Experience in roles emphasizing production and quality metrics.
• Excellent time management and organizational abilities.
• Demonstrated investigative research skills.
• Ability to work both independently and collaboratively to meet shared objectives.
• High attention to detail and openness to change.
• Capacity to maintain confidentiality and discretion handling sensitive information securely.