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Center for Health Care StrategiesCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing open receivables, including billing, coding, and insurance processes. Proficient in utilizing Epic for data entry and maintaining accurate documentation while providing exceptional customer service.
Highest-signal resume keywords
Claim Follow-Up ActivitiesInsurance Denials ManagementEpic Data EntryCustomer Service ExcellenceBilling Adjustments
About the role
Key responsibilities & impact- Facilitate resolution of open receivables by reviewing coding, billing, contracts, and authorization terms
- Diagnose and report rejection and denial trends to management
- Maintain accurate documentation of claim follow-up activities
- Process customer service requests for adjustments, account type changes, guarantor merges, and transfers according to enterprise guidelines
- Address insurance denials and underpayments by appealing or adjusting balances and billing guarantors for patient responsibility
- Enter patient demographics, guarantor, and coverage information into Epic
- Change filing order, ensure necessary account adjustments are listed, distribute payments to correct service dates, and request changes when needed
- Keep abreast of insurance and system changes and provide excellent customer service reflecting Nemours' Mission, Vision, and Values
Requirements
What you’ll need- High School Diploma
- 1-3 years of relevant experience
- Applicants must reside in one of the following states: Alabama, Colorado, Delaware, the District of Columbia, Florida, Georgia, Illinois, Maryland, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding ReviewBilling ReviewContract AnalysisAuthorization TermsClaim ProcessingAdjustment ProcessingDenial Trends DiagnosisPayment DistributionAccount AdjustmentsPatient Demographics Entry
Soft Skills
Excellent Customer ServiceAttention to DetailProblem SolvingCommunication SkillsAdaptability
Tools & Technologies
Epic
Certifications & Qualifications
High School Diploma
Industry Keywords
Receivables ManagementInsurance ClaimsPatient ResponsibilityGuarantor MergesAccount Type Changes