Claims Specialist

Summary

Seeking experienced professionals to handle accounts receivable follow-up, focusing on resolving appeals and denials within healthcare revenue management. Candidates will assist in optimizing financial performance by managing facility patient accounts, supporting billing processes, and ensuring timely resolution of claims issues. The role involves proactive review, analysis, and communication to improve collection outcomes and maintain compliance.

Requirements

• High school diploma or equivalent required; bachelor’s degree preferred
• Previous supervisory experience is a plus
• Minimum of two years’ experience in patient account management in a facility, hospital, or physician practice setting
• Proficiency with word processing and spreadsheet software
• Strong knowledge of bookkeeping, billing, and collections practices
• Excellent communication, organizational, and interpersonal skills
• Good personal credit report

Responsibilities

• Assist with billing, collections, insurance verification, and medical records
• Review and analyze accounts receivable activities, identify issues, and proactively recommend improvements
• Support claim resolution, appeals, and denials resolution efforts
• Ensure accuracy and timeliness of daily and monthly AR processes
• Maintain compliance with policies and procedures, internal controls, and contractual agreements
• Assist with preparing financial reports, performance analysis, and month-end close procedures
• Support system maintenance related to revenue cycle management and accounts receivable reporting
• Keep skills current through ongoing training and technology adoption