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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. Possesses excellent organizational and communication skills to effectively manage accounts and maintain productivity in a remote environment.
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 AwarenessICD-10HCPCSMedical TerminologyAnalytical AbilitiesResearch Skills
Soft Skills
Strong Communication SkillsInterpersonal SkillsOrganizational SkillsTime-Management SkillsInvestigative Skills
Tools & Technologies
Billing SoftwarePayer PortalsMicrosoft OfficeWeb Platforms
Industry Keywords
HIPAA ComplianceAccounts ReceivableSelf-Pay AccountsCollections ManagementHealthcare Industry
About the role
Key responsibilities & impact- Make telephone calls to patients, hospitals, insurance companies, facilities, and attorneys to research claims or obtain additional insurance information
- Contact insurance carriers regarding the status of past-due accounts
- Meet or exceed defined 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
- Maintain workflow and minimize aging accounts by following up on unpaid claims daily
- Follow up on accounts that have reached collections before referral to an external collection agency
- Complete assigned special projects
- Perform quality checks on assigned claims
- Maintain confidentiality
- Perform responsibilities according to company standards and state and federal guidelines
- Ensure compliance with laws and regulations, including HIPAA
- Adhere to company attendance policies
- Perform additional duties as assigned
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, including understanding 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, research, 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
Benefits
Comp & perks- Competitive salary, commensurate with experience
- Comprehensive benefits package
- 401(k) Plan
- Remote work arrangement
