Claims Resolution Specialist

At Ivinson Memorial Hospital we are committed to excellence, trust, healing, and integrity. We pride ourselves in providing compassionate, world-class care to our community. At Ivinson we offer a competitive total rewards package including; full medical, dental, and vision insurance, retirement plans, paid time off and tuition reimbursement opportunities. Ivinson aims to improve the care provided for our patients and create a work-life balance for our employees by creating a culture of transparency, teamwork, accountability, and trust.

Position Summary
The Claims Resolution Specialist reviews and analyzes claims and follows up on the status of claims and reimbursement.

Base Salary Starting At: $15.73

Essential Functions

  • Contacts payers to follow up on claims status and obtain reimbursement.
  • Re-bills claims with applicable corrections.
  • Receives payments from patients and provides customer service as needed.
  • Addresses discrepancies in charges, payments, adjustments, and demographic information.
  • Researches all accounts with credit balances and processes refunds.
  • Other duties as assigned.

Qualifications
Education

  • High school diploma or equivalent preferred.

Experience

  • Hospital billing software experience strongly preferred.

Credentials

  • N/A

Knowledge, Skills and Abilities

  • Knowledge of third party billing procedures strongly preferred.
  • Knowledge of claims review and analysis strongly preferred.
  • Knowledge of Medicare, Medicaid and HMO contracts strongly preferred.
  • Strong working knowledge of Microsoft Office applications.
  • Excellent customer service skills, including but not limited to: a friendly personality, tact, patience, empathy and a helpful, professional attitude both in person and on the telephone.
  • Ability to effectively communicate with staff, managers and the general public verbally and in writing.
  • Demonstrate effective listening skills.
  • Excellent organization and time management skills and ability to establish priorities effectively.
  • Possess exceptional problem-solving skills.
  • Ability to work effectively without immediate supervision.
  • Ability to learn new computer software programs.
  • Ability to recognize and protect confidential information.
  • Demonstrate ethical and legal accountability for the position.
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