Claims Resolution Specialist - Carrier Relations

The Claims Resolution Specialist plays a key role in resolving open receivables for our clients.

You will process medical (physician and hospital) bills that involve motor vehicle accidents, workers' comp, and third-party claims. The Claims Resolution Specialist will work toward increased reimbursement and account resolution.

Responsibilities :

• Works independently to identify issues with claim submissions; identifies corrective steps; follows issue through to resolution.
• Provide exceptional customer service for inbound calls.
• Interface with insurance agents, patients, and others to the disposition of each account.
• Identify obstacles to claim submission and payment, including updating insurances, adjuster contact information, submitting bills, and providing requested documentation.
• Identify patterns with payers that result in non-payment or delayed payment. Ability to summarize and escalate in the correct manner.
• Update accounts in our proprietary technology platform to increase probability of collection and resolution of accounts.
• Rely on experience and judgment as well as instructions and pre-established guidelines to plan and accomplish goals and perform a wide variety of tasks.

Required Skills :

Education and Experience :

Other relevant info :

Why Medlytix ?

As part of our commitment to quality and excellence, Medlytix will continue to maintain a safe and healthy environment for you by requiring all applicants to submit to a criminal history check and those tentatively selected for a position to submit to screening for illegal drug use prior to appointment for a job. In addition, applicants may be screened for ability to perform essential functions of some positions.