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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing denied claims and understanding insurance payer requirements while maintaining HIPAA compliance. Possesses strong problem-solving abilities, excellent communication skills, and a detail-oriented approach to monitoring reports and identifying trends.
Highest-signal resume keywords
Analytical Work On Denied ClaimsKnowledge Of Insurance Payer RequirementsProblem-Solving SkillsExcellent Customer Service SkillsHIPAA Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Analytical WorkClaim-Denial Resolution StrategiesReimbursement PoliciesMonitoring ReportsBilling Reports
Soft Skills
Professional DemeanorDetail-OrientedStrong Decision MakerStrong CommunicatorFlexible And Adaptable
Tools & Technologies
Internal ProgramsTechnology Comfort
Industry Keywords
HealthcareHealth InsuranceHIPAACompliance RulesInsurance Audits
About the role
Key responsibilities & impact- Perform analytical work on denied claims
- Research insurance payer requirements
- Solve problems and find innovative solutions
- Make and receive calls professionally
- Monitor reports to identify trends, concerns, and areas of improvement
- Discuss findings, with potential reporting to management
- Address denied claims sent to insurance for payment
- Provide medical documentation to insurance carriers
- Address insurance audits
- Maintain HIPAA/patient confidentiality
- Complete assigned billing reports independently after training
- Answer phone calls independently
- Collaborate in supervisor Q&A sessions, team meetings, and relevant support-team meetings
- Spend approximately 25% of time collaborating and 75% working independently
- Complete training on internal programs, claim-denial resolution strategies, key metrics/KPIs, and compliance rules
Requirements
What you’ll need- 2 years recent work history
- Prior work experience in healthcare or health insurance
- Bachelor’s degree from an accredited university in any field is desired
- Analytical work of denied claims
- Knowledge of insurance payer requirements
- Ability to solve problems and find innovative solutions
- Ability to prioritize multiple responsibilities
- Professional demeanor when making and receiving calls
- Understanding of reimbursement policies
- Comfort with technology
- Ability to monitor reports and identify trends, concerns, and areas of improvement
- Detail-oriented and critical thinker
- Excellent customer service skills
- High level of organization
- Strong decision maker
- Strong communicator
- Flexible and adaptable
- Empathetic, compassionate, and inclusive
- Maintain HIPAA/patient confidentiality
- Regular and reliable attendance as assigned by schedule
- Knowledge of and compliance with applicable laws, regulations, and policies
Benefits
Comp & perks- Competitive pay
- Health plans with FSA or HSA options
- Dental insurance
- Vision insurance
- Optional life insurance
- 401(k) with company match
- 12 weeks of parental leave for birthing parent
- 4 weeks of parental leave for non-birthing parent(s)
- Fertility stipends
- Free diapers
- Breast pump
- Paid holidays
- PTO accrual from day one
- Employee Assistance Programs
- Career building and promotion-from-within opportunities