Resolution Analyst, Denials

📋 Description

• Review and appeal denied/underpaid claims using EnableComp tools.
• Use payer documentation and provider contracts to determine reimbursement.
• Review hospital contracts to collect cash from insurers for denials.
• Gather medical records and submit complex underpayment appeals to payers.
• Conduct timely follow-up calls with payers to resolve receivables.
• Ensure smooth operations and improve customer satisfaction.

🎯 Requirements

• High School Diploma or GED; Associates/Bachelor’s preferred.
• 5+ years in healthcare billing/collections.
• 1+ year client-facing/customer service experience.
• ICD, HCPCS/CPT coding and medical terminology.
• Familiarity with HMO/PPO/IPA, capitation terms; payer contracts.
• MS Office proficiency (Word, Excel, Outlook) and basic office skills.

🎁 Benefits

• Equal Opportunity Employer (M/F/D/V).
• Core values, professional growth, supportive culture.
• Flexible, family-oriented environment balancing work and life.
• Recognized Top Workplace; strong growth and reputation.