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Meduit | Driving Revenue Cycle PerformanceCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in insurance claims resolution, including denial management, appeals preparation, and compliance with HIPAA regulations. Proficient in utilizing healthcare revenue cycle systems and managing accounts receivable to ensure timely reimbursement.
Highest-signal resume keywords
Insurance Claims ResolutionDenial ManagementHealthcare Revenue Cycle ExperienceEpic ProficiencyMedical Billing Knowledge
About the role
Key responsibilities & impact- Research and resolve denied, unpaid, underpaid, or incorrectly processed insurance claims
- Investigate claim rejections and denials by contacting insurance carriers and reviewing payer requirements
- Follow up with Medicare, Medicaid, Blue Cross, and commercial insurance carriers to obtain claim status updates and payment resolution
- Analyze denial codes, remittance advice, payer correspondence, and claim documentation to identify root causes and determine appropriate next steps
- Correct claim errors and facilitate claim resubmission to support timely reimbursement
- Prepare and submit appeals, reconsiderations, corrected claims, and supporting documentation as needed
- Manage assigned claim inventory and prioritize accounts to reduce aging accounts receivable
- Contact patients when necessary to obtain or verify information needed to resolve billing or insurance issues
- Review and update patient demographics, insurance information, and account details when necessary to facilitate claim resolution
- Document all account activity, payer communications, and claim resolutions accurately and timely
- Communicate professionally with insurance companies, patients, and client representatives regarding outstanding claims and balances
- Identify denial trends and recurring issues and communicate findings to leadership and operational teams
- Meet established productivity, quality, and cash collection performance standards
- Maintain compliance with HIPAA regulations, client requirements, and company policies
- Collaborate with Billing, Claims, Collections, and Client Services teams to resolve complex reimbursement issues
- Report to the Insurance Supervisor
Requirements
What you’ll need- High School Diploma or GED
- 2+ years of experience in insurance follow-up, denials management, accounts receivable (AR) follow-up, medical billing, healthcare collections, or related healthcare revenue cycle functions
- Experience working with Medicare, Medicaid, and commercial payers
- Experience with hospital billing and/or physician billing processes
- Experience verifying insurance eligibility, benefits, authorizations, and resolving payer-related claim issues
- Knowledge of patient billing, claims submission, reimbursement, denial resolution, and follow-up processes
- Experience using Epic within healthcare revenue cycle systems
- Proficiency with Microsoft Office (Outlook, Word, and Excel)
- Secure and private workspace within the home
- Reliable wired (preferred) high-speed internet connection
- Minimum internet speeds of 30 Mbps download and 10 Mbps upload
- Ability to maintain a professional and distraction-free work environment during scheduled working hours
- Legally authorized to work in the United States at the time of hire
- Candidates residing in New York are not eligible
- Successful completion of a pre-employment background check
- Preferred: 3+ years of healthcare revenue cycle, insurance follow-up, denial management, or medical billing experience
- Preferred: Experience in a hospital, physician practice, or healthcare revenue cycle environment
- Preferred: Experience using Cerner, Meditech, or other healthcare information systems
- Preferred: Experience obtaining prior authorizations and navigating payer-specific requirements
- Preferred: Experience utilizing payer portals such as Availity, NaviNet, Experian Health, or similar platforms
- Preferred: Knowledge of medical terminology, CPT, HCPCS, and ICD-10 coding principles
- Preferred: Previous remote healthcare revenue cycle experience
Benefits
Comp & perks- Medical, Dental & Vision
- 401(k) with Company Match
- Paid Wellness Time & Holidays
- Employer-Paid Life Insurance & LTD
- Paid Training
- Internal Growth Opportunities
- Work-from-home position
- Secure and private home workspace
- Paid training
- Internal growth opportunities
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 SubmissionDenial ResolutionAccounts Receivable Follow-UpInsurance Eligibility VerificationReimbursement ProcessesCPT CodingICD-10 CodingHCPCS CodingPayer Correspondence AnalysisAppeals Preparation
Soft Skills
Professional CommunicationProblem-SolvingAttention to DetailTime ManagementCollaboration
Tools & Technologies
EpicCernerMeditechAvailityNaviNetExperian HealthMicrosoft Office
Industry Keywords
Healthcare CollectionsMedicareMedicaidCommercial InsurancePatient BillingRevenue Cycle ManagementClaim Denial TrendsPayer RequirementsRemote Healthcare ExperienceBackground Check Compliance