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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in researching and resolving health insurance claims, including commercial health, Medicare, and Medicaid, while ensuring accurate filing of UB04 and 1500 HCFA forms. Proficient in managing high volumes of claims and maintaining productivity in a fast-paced environment.
Highest-signal resume keywords
Claims Research and ResolutionUB04 and 1500 HCFA FilingEPIC ExperienceMicrosoft Office ProficiencyHigh Volume Call Management
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 InvestigationHealth Insurance BillingSubrogation Information HandlingTimely Claim Follow-UpProductivity Metrics Management
Soft Skills
Strong Performance Under PressureAttention to DetailEffective Communication
Tools & Technologies
EPICMicrosoft WordMicrosoft ExcelMicrosoft Outlook
Industry Keywords
Commercial Health ClaimsMedicare ClaimsMedicaid ClaimsDenial ReportsAudit Support
About the role
Key responsibilities & impact- Bill and investigate health insurance claims to maximize payment from insurance companies for hospital and medical-provider clients
- Research and investigate commercial health, Medicare, and Medicaid claims
- Follow up on unresolved claims to facilitate payment
- Maximize payments to medical-provider clients
- Contribute to denial reports, audits, and overall team support
- Complete interactive training and hands-on activities during the 8–10 business-day training period
Requirements
What you’ll need- Experience researching and resolving claims for commercial health, Medicare, and Medicaid
- Knowledge of filing correct UB04s and 1500 HCFA forms with subrogation information
- Familiarity with billing health insurance as part of auto accidents
- Experience conducting timely claim follow-up to determine claim status and collect or provide information
- Experience working in EPIC
- Working knowledge of Microsoft Office (Word, Excel, Outlook)
- Technical proficiency working on multiple computer screens and software applications simultaneously
- Ability to maintain strong performance in a fast-paced environment with productivity metrics
- Private, distraction-free home work environment
- Secure internet connection
- Home internet speeds above 20 Mbps download and above 10 Mbps upload
- Workspace able to accommodate provided workstation equipment
- Eligibility to work in the United States
- Successful employment history verification and background check
- Must reside in the United States within one of the listed eligible states
- Full focus during scheduled work hours and ability to meet productivity expectations
- Active participation on camera
- Ability to manage a high volume of inbound and outbound calls while maintaining accuracy and productivity standards
Benefits
Comp & perks- Incentive Plan
- Comprehensive training beginning on the first day and lasting 8–10 business days
- Ongoing support from teammates following training
- Robust knowledgebase for continued reference
- Individual performance metrics for goal setting
- Computers and necessary work equipment provided
- Involved management support
- On-camera remote work culture
- Affirmative Action/Equal Opportunity Employer