- Monitor aging buckets over 30 days for claims that have been transmitted but not adjudicated
- Contact insurance companies via payer portal, payer chat, or phone
- Monitor timely filing limits
- Document all account activities
- Locate missing remits and/or payments
- Resolve payer issues
- Submit requested documentation
- Coordinate claim corrections with the appropriate department
- Escalate complex issues
- Update identified registration errors
- Identify process improvement opportunities
- Research unpaid claims
- Communicate identified trends to leadership
- Keep AR days under 40 days
- Meet or exceed the organization's cash goal
- Keep AR under 90 days below 25%
- Perform other essential duties as assigned
Requirements
- High school diploma or equivalent
- 2+ years of healthcare billing or revenue cycle experience
- Residency in Missouri or Kansas is required
- Experience working in an EHR system (MEDITECH preferred)
- Basic understanding of CPT, HCPCS, and ICD-10 coding
- Knowledge of insurance billing processes
- Understanding of Explanation of Benefits
- Attention to detail and accuracy
- Time management and ability to meet deadlines
- Strong organizational skills
- Effective communication and teamwork
- Ability to follow standardized workflows
- Maintain regular and predictable attendance
- Ability to sit and stand intermittently for 8 to 10 hours a day
- Ability to use standard office equipment, including telephone and computer keyboard
- Ability to work under pressure while meeting near-100% accuracy and inflexible deadlines
- Manual/bi-manual dexterity, near vision, speech, and hearing
- Ability to lift or carry up to 40 lbs.
Core Competencies
Demonstrates expertise in healthcare billing and revenue cycle management, with a strong focus on claims monitoring, documentation accuracy, and effective communication with insurance companies. Proficient in utilizing EHR systems and understanding coding standards to ensure timely and accurate claims processing.
Highest-signal resume keywords
- Healthcare Billing Experience
- EHR System Proficiency
- CPT, HCPCS, ICD-10 Coding Knowledge
- Claims Monitoring and Resolution
- Effective Communication Skills
ATS Optimization Keywords
Hard Skills
- Healthcare Billing
- Revenue Cycle Management
- Claims Processing
- CPT Coding
- HCPCS Coding
- ICD-10 Coding
- Documentation Accuracy
- Timely Filing Monitoring
- Process Improvement
- Account Activity Documentation
Soft Skills
- Attention to Detail
- Time Management
- Organizational Skills
- Teamwork
- Ability to Work Under Pressure
Industry Keywords
- Claims Adjudication
- Explanation of Benefits
- Accounts Receivable Management
- Insurance Billing Processes
- Aging Buckets Monitoring
Tools & Technologies
- EHR System
- MEDITECH
- Payer Portal
- Payer Chat
- Standard Office Equipment
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Payer Account Resolution Specialist Arbeitgeber: Jobtailor
Als Front Office Supervisor in unserem dynamischen Team bieten wir Ihnen die Möglichkeit, in einem unterstützenden und freundlichen Arbeitsumfeld zu wachsen. Wir legen großen Wert auf die berufliche Entwicklung unserer Mitarbeiter und bieten regelmäßige Schulungen sowie die Chance, Verantwortung zu übernehmen. Unsere Lage ermöglicht es Ihnen, Teil einer lebendigen Gemeinschaft zu sein, während Sie gleichzeitig die Standards unseres Franchise-Partners einhalten und unseren Gästen einen unvergesslichen Aufenthalt bieten.
