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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 and billing, with a strong understanding of insurance appeals, remittance advices, and compliance with HIPAA regulations. Proven ability to manage accounts receivable effectively while maintaining high standards of customer service and organizational skills.
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
Claims ProcessingInsurance BillingRemittance Advice UnderstandingPayer Denial Codes KnowledgeTimely Filing Limits KnowledgeICD-10 FamiliarityHCPCS FamiliarityBilling Software ProficiencyMicrosoft Office ProficiencyInvestigative Skills
Soft Skills
Strong Communication SkillsInterpersonal SkillsOrganizational SkillsTime-Management SkillsCritical Thinking
Tools & Technologies
Web PlatformsBilling SoftwarePayer Portals
Industry Keywords
HIPAA ComplianceHealthcare BillingAccounts ReceivablePatient BillingSelf-Pay Accounts
About the role
Key responsibilities & impact- Support all aspects of insurance and patient billing to ensure prompt and accurate payment to clients or providers
- Call patients, hospitals, insurance companies, facilities, and attorneys to research claims or obtain insurance information
- Contact insurance carriers about past-due account status
- Meet or exceed productivity and quality standards
- Document account activity in the claims processing system
- Follow up on self-pay accounts, inquire about insurance coverage, and establish payment plans
- Follow up daily on unpaid claims to minimize aging accounts
- Ensure accounts sent to collections have been fully worked before external referral
- Complete assigned special projects
- Perform quality checks on assigned claims
- Maintain confidentiality
- Perform duties according to company standards and state and federal guidelines
- Maintain compliance with applicable laws and regulations, including HIPAA
- Adhere to company attendance policies
- Perform additional assigned duties
Requirements
What you’ll need- High School Diploma or equivalent required
- Minimum of 1 year of experience in healthcare claims processing, billing, or accounts receivable
- Hands-on experience preparing and submitting insurance appeals
- Understanding of remittance advices, 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 web platforms, billing software, and payer portals
- Prior customer service experience
- Basic computer knowledge and experience using Microsoft Office
- Strong customer service, interpersonal, organizational, communication, and time-management skills
- Strong investigative and research skills
- 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 role, including required goals and business practices, in a remote environment
- Ability to meet company standards, state and federal guidelines, HIPAA requirements, and attendance policies
Benefits
Comp & perks- Competitive salary, commensurate with experience
- Comprehensive benefits package
- 401(k) Plan
- Remote work arrangement
- Equal Opportunity Employer
- Inclusive workplace that promotes and values diversity
