Washington, District of columbia
Claims Resolution Coordinator Job Opening in Washington, District of columbia - We are looking for a skilled Claims Resolution Specialist to join our team. This is a fast paced environment, that reports to the Operations Management team assigned to, perform a variety of duties and responsibilities related to billing and claim resolution for assigned hospitals and Vendors. This includes the transactions of the hospital billing system, as well as its? coordination with all other related hospital systems and departments. Individuals assigned this classification will perform some or all of the duties listed as required.
Responsibilities:
Research and provide resolution for departmental claim data for claim liens and correspond with Law office(s) for legal medical claims and provide detailed account analysis. Assist vendors with updates of claims and process changes within the claims department. Develop weekly Plan Overview report for the Health Plan?s top 7 vendors. Collaborate events with the Provider Relation Team for training and other tutorial with the portal and new business for the Health timely responses to external and internal clients Review incoming mail/claims for disputes and possible appeals.
Qualifications:
- A minimum of two years of medical billing experience.
- Experience with claim resolution for multiple payers.
- Knowledge of ICD-10 and HCPC codes, XEROX, and eligibility tools
- Experience working with Health Care business systems
- Experience working in a managed care environment preferred
- Proficient in Microsoft Office tools (Excel, PowerPoint)
- Should have a high level of understanding the claims process
- Complete knowledge of the hospital revenue cycle.
Trusted Health Plan (THP) has been awarded the opportunity to serve the people of Washington D.C. by helping our neighbors obtain the services they need to lead a long and healthy life.
Trusted Health Plan (THP) is different. We are a D.C. Organization, staffed by many D.C. employees committed to serving our neighbors and community.
We are headquartered east of the river to ensure convenient access to members living in Wards 7 & 8. We are local and are here to provide outstanding support to our membership. Trusted Health Plan offers a fast paced unique work environment, a results driven team, and an excellent benefits package.
Benefits include; medical, vision, dental, life insurance, STD/LTD, retirement plan with company match, company paid VIDA fitness gym membership.
Qualified and DC local candidates should apply today for immediate consideration!
Required experience:
Medical Billing/ Healthcare Claims Resolution: 2 years
Previous MCO/ Healthplan environment strongly preferred
Job Type: Full-time
Job Location:
Washington, DC
Required education:
Bachelor's
Required experience:
Claims Processing: 3 years
Managed Care Organization: 2 years
Required license or certification:
Billing and Coding Specialist
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