Resolution Specialist - Medicare HMO Job at Acadian Ambulance
Acadian Ambulance has an opening for a Resolution Specialist - Medicare HMO to work with our Acadian Client Services team. The Resolution Specialist is responsible for processing, compiling, analyzing and managing the receivables for assigned payor type.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Claim status check and resolution, including initiating contact with appropriate third-party payer
Claim rejection/denial and resolution, including initiating contact with appropriate third-party payer
Review Timely Filing reports/invoices
Monitor payment variance with resolution
Process payments including reconciling unapplied cash
Research payor issues
Handle inbound calls
Verification tasks specific to payer type
Ensure accuracy of demographic information
Other duties and responsibilities, as assigned
QUALIFICATIONS:
3+ years of Medicare/HMO experience
Previous insurance billing experience preferred
Proficient in Google, MS Office Suite or related software
Understands HIPAA and Red Flag guidelines
Problem-solving abilities
Excellent communication and customer relation skills
Familiarity with the Centers for Medicare & Medicaid Services regulations (ambulance)
Demonstrate a strong work ethic and work independently
Possess strong organizational skills
Punctual with strong attendance history
Ability to adhere to productivity goals, departmental and company guidelines, dress code, policy and procedures
Excellent interpersonal skills and time management
Maintain highest level of confidentiality
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