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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare claims processing, billing, and accounts receivable management, with a strong understanding of insurance appeals and compliance with HIPAA regulations. Proficient in utilizing billing software and payer portals to ensure accurate and timely payment while maintaining high productivity standards.
Highest-signal resume keywords
Healthcare Claims ProcessingInsurance Appeals PreparationICD-10 FamiliarityBilling Software ProficiencyCustomer Service Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Healthcare Claims ProcessingInsurance Appeals PreparationICD-10 FamiliarityHCPCS KnowledgePayer Denial Codes UnderstandingBilling Follow-UpAccounts Receivable ManagementQuality Checks on ClaimsProblem-Solving SkillsAnalytical Abilities
Soft Skills
Interpersonal SkillsOrganizational SkillsCommunication SkillsTime-Management SkillsCritical Thinking
Tools & Technologies
Billing SoftwarePayer PortalsMicrosoft Office
Industry Keywords
Revenue Cycle ManagementInsurance DenialsPatient BillingCompliance with HIPAAMedical TerminologyEMS Billing Experience
About the role
Key responsibilities & impact- Support revenue cycle activities related to outstanding insurance accounts receivable, insurance denials, and appeals
- Perform insurance and patient billing follow-up to ensure prompt and accurate payment
- Perform job responsibilities according to company standards and state and federal guidelines
- Contact patients, hospitals, insurance companies, facilities, and attorneys to research claims or obtain insurance information
- Inquire with insurance carriers about past-due account status
- Meet or exceed defined productivity and quality standards
- Document account activity in the claims processing system
- Follow up with patients regarding insurance coverage
- Maintain workflow and minimize aging accounts by regularly following up on unpaid claims
- Follow up on accounts in collections before referral to an external collection agency
- Complete special projects assigned by the Manager
- Demonstrate compliance with applicable laws and regulations, including HIPAA
- Problem-solve and resolve complex accounts and escalations
- Perform quality checks on assigned claims
- Adhere to company attendance policies
- Perform additional duties as assigned
Requirements
What you’ll need- High School Diploma or equivalent required
- Associates Degree preferred
- Minimum of 2 years’ experience in healthcare claims processing, billing, or accounts receivable
- Hands-on experience preparing and submitting insurance appeals, including understanding payer denial codes and payer timely filing limits
- Familiarity with ICD-10, HCPCS, and general medical terminology
- EMS billing experience strongly preferred; experience in other medical specialties will be considered
- Proficiency with various web platforms, including billing software and payer portals
- Prior customer service experience
- Ability to work collaboratively with other departments and team members
- Basic computer knowledge and experience using Microsoft Office
- Strong interpersonal, organizational, communication, and time-management skills
- Strong investigative and research skills, with the ability to resolve complex billing issues
- Effective critical thinking and analytical abilities
- Ability to work independently in a fast-paced, adaptive environment with minimal supervision
- Ability to independently manage all aspects of the job role, including required goals and business practices, in a remote environment
- Must comply with applicable laws, regulations, HIPAA, and company standards
Benefits
Comp & perks- Competitive salary, commensurate with experience
- Comprehensive benefits package
- 401(k) Plan
- Remote work arrangement
