FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing insurance claims, including submission, follow-up, and appeals, while ensuring compliance with payer-specific requirements and regulations. Proficient in utilizing EMR/EHR systems and maintaining high-quality standards in the healthcare revenue cycle.
Highest-signal resume keywords
Medical Claim ManagementICD-10 CodingEMR/EHR Systems ProficiencyPayer Guidelines KnowledgeClaims Follow-Up and Appeals
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical Claim ProcessingClaim Error InvestigationPayment ValidationCoding PrinciplesRevenue Cycle Knowledge
Soft Skills
Strong Communication SkillsDecision-Making AbilityIndependent Work Capability
Tools & Technologies
Microsoft Office SuiteTeamsMeditechEpicCernerAllscriptsNextgen
Industry Keywords
Healthcare Revenue CyclePayer-Specific Billing RequirementsClaims Denial ManagementQuality AssuranceInsurance Accounts Receivable
About the role
Key responsibilities & impact- Manage insurance claims for clients, ensuring accurate and timely payment processing
- Submit medical claims according to federal, state, and payer-specific requirements
- Review and correct claim edits, errors, and denials
- Investigate and analyze claim errors and rejections and apply necessary corrections
- Follow up with payers and collect assigned insurance accounts receivable
- Stay informed about payer updates and process changes
- Evaluate non-payment reasons and resolve claims for clients
- Prepare and submit first- and second-level appeals with supporting documentation
- Identify and document coding, clinical, and registration issues for referral to appropriate teams
- Escalate stalled claims to payers or Currance leadership
- Verify and adjust claims so client accounts reflect correct liability and balances
- Identify payer-specific issues and communicate them to the team and manager
- Achieve 100% of the project daily goal
- Achieve a 90% monthly quality assurance score
- Perform other duties assigned to support business needs
Requirements
What you’ll need- High school diploma or equivalent
- Minimum 2 years of experience securing medical claim payments from health insurance companies
- Experience managing claim follow-up and appealing denied claims with healthcare vendors or providers
- Experience using EMR/EHR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms
- Strong working knowledge of ICD-10, CPT/HCPCS, payer guidelines, and the revenue cycle process
- Strong written and verbal communication skills, with ability to advocate effectively with payers
- Proficiency in Microsoft Office Suite, Teams, and various desktop applications
- Current knowledge of basic coding principles and payer-specific billing requirements
- Knowledge of regulations and rules related to Healthcare Revenue Cycle administration
- Skilled in investigating medical accounts
- Ability to validate payments
- Capable of making decisions and taking action
- Ability to quickly learn and use collaboration and messaging tools
- Ability to work independently and achieve results with minimal oversight
- Subject to criminal background and government exclusion checks as a condition of employment or engagement
Benefits
Comp & perks- Remote position
- Criminal background check and government exclusion check as part of the hiring process