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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare billing and collections, particularly in workers' compensation, while effectively managing client relationships and team performance. Proficient in claims processing and utilizing analytical skills to resolve issues and improve operational efficiency.
Highest-signal resume keywords
Healthcare Billing ExperienceWorkers Compensation Claims ProcessingClient Relationship ManagementSupervisory ExperienceAnalytical Problem-Solving
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ProcessingBilling and CollectionsData AnalysisPerformance EvaluationQuality ControlDocument ManagementProprietary Software ProficiencyMS Office SuitePPO Contract VerificationMedical Record Research
Soft Skills
Interpersonal SkillsService-Oriented ApproachCoaching and MentoringCommunication SkillsStress Management
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Revenue ServicesClient Issues ResolutionHealthcare FieldExternal Client CommunicationProtected Health Information
About the role
Key responsibilities & impact- Supervise assigned Revenue Services teams daily
- Serve as the primary escalation point for claims-resolution roadblocks and client issues
- Direct Account Managers and Revenue Specialists in resolving claims and client issues
- Partner with Managers to prioritize daily team tasks
- Prepare performance evaluations and account reviews with the Department Leader
- Analyze and evaluate claim payments using proprietary software, systems, and tools
- Verify provider reimbursement against applicable state workers’ compensation fee schedules and PPO contracts
- Research and acquire medical records, implant manufacturer invoices, and supporting documentation for claims reimbursement
- Coordinate internal communication and messaging for external client requests and issues
- Create, review, and maintain external-facing client reports
- Facilitate internal and external process-improvement and issue-resolution meetings
- Respond to external clients regarding remote system access, document requests, payment research, and end-user training
- Conduct telephone follow-up with insurance companies to ensure proper reimbursement
- Prepare initial bill packets and appeal letters
- Collaborate with Data Analytics, Data Quality, and Document Management teams
- Train and mentor staff, including new hires
- Perform quality-control tasks for account flow and due diligence
- Manage more difficult client accounts
- Participate in hiring, training, performance management, and corrective action throughout the employee lifecycle
- Handle protected health information and maintain confidentiality and security
- Support operational initiatives through team collaboration
- Perform other duties as required
Requirements
What you’ll need- High School Diploma or GED required
- 5 years’ experience in healthcare field working in billing or collections
- 5 years’ client facing/customer services experience
- 1-2 years supervisory or team lead experience
- 3-5 years’ experience with workers compensation billing and collections preferred
- Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements
- Strong computer proficiency and basic office applications, including MS Office (Word, Excel, and Outlook)
- Equivalent combination of education and experience will be considered
- Regular and predictable attendance
- Exceptional interpersonal skills and approachable nature
- Service-oriented approach, strong sense of urgency, and ability to develop and coach team members
- Ability to work independently without direct supervision
- Proven written and verbal communication skills
- Strong analytical and problem-solving skills
- Ability to handle stress and interact cooperatively at all organizational levels
- Proven experience working with external clients, strong customer service skills, and business acumen
- Ability to prioritize and manage multiple competing priorities and projects concurrently
- Ability to sit for long periods of time
Benefits
Comp & perks- Full-time employment
- Professional growth and development opportunities
- Tools, resources, and support for career growth
- Flexible, family-oriented workplace
- Work-life balance support
- Top Workplaces-recognized employer