BayCare Health System
Green Bay, WI, United States
Sep 15, 2021
Dec 29, 2021
Our Patient Accounts department is seeking a Claims Resolution Specialist to join their team! The hours for this position are Monday-Friday, 8:30am-5pm, 40 hours per week and the position is located at BayCare's Corporate Office in beautiful, downtown Green Bay.
The Claims Resolution Specialist performs tasks required to maximize the aging an ensure timely resolution of all insurance balances for BayCare Clinic and its patients. This individual will work collaboratively with all departments across the organization, to include clinic practice sites.
Description of Duties:
Researches and processes denials from all payers in a timely manner, with an awareness of payer-specific policies, to obtain payment or propose financial adjustments/write-offs.
Demonstrates effective decision making skills in dealing with the payers to resolve the claim to include: making appropriate inquiries of the payers, editing and re-filing of claims, assuring follow-up activities and managing correspondence.
Identifies problems with accounts and follows through to resolution, notifying supervisor or appropriate personnel of trends/problems involving claims and/or payers.
Demonstrates BayCare Health Systems operational knowledge and system competency to effectively resolve inquiries and issues.
Complies and adheres to pertinent policies and procedures.
Maintains high quality and productivity levels.
Respects and maintains confidentiality.
Works in a safe, compliant, and ethical manner at all times.
Supports the Customer Service and Collections phone hunts as needed.
Works to build customer loyalty.
Participates in various projects as assigned.
A minimum of three years’ experience in a patient accounts setting with knowledge of the patient account continuum, claims processing and insurance benefits, medical terminology, CPT, ICD-9, HCPCS, RVU, coding, state and federal regulatory compliance laws, customer service, is strongly preferred.
Experience with dental claims is a plus.
Knowledge of insurance principles and insurance contracts.
Proficient with Microsoft Word, Excel, and internet.
Strong writing and verbal skills with ability to communicate complex concepts.
Problem solving skills, ability to systematically analyze problems, draw relevant conclusions, and devise appropriate courses of action.
Self-starter with the ability to work independently.
Excellent interpersonal, communication and organizational skills.
BayCare Health System
Website : https://baycare.org/