Remote Medical Claims Processing

FULLY REMOTE BUT MUST SIT IN JACKSONVILLE, FL

Insight Global is looking an experienced Medical Claims Resolution Specialist II for a client of ours in Jacksonville, Florida. This person will be responsible for the full cycle of claims assigned. This individual should be experienced and comfortable utilizing EPIC and experienced with medical claims processing.

DAY- TO-DAY

• Work through their denials based on priority and allocation
• Report trends within claim denials or billing errors
• Subject to periodic audits
• Reviewing correspondence and making an appeal or reaching out to gather more information
• Responsible for the denial queue and the no-response queue (could shift) in addition to a correspondence queue used to submit records
• Follow up on claims and work them to zero balance resolution through methods like connecting with payer directly, using payer portal, formal appeal, etc.
• Working to meet production standards