Claims Resolution Specialist Position Available In Lafayette, Louisiana
Tallo's Job Summary: The Claims Resolution Specialist position based in Lafayette, LA involves reviewing insurance policies, medical documentation, and resolving back collections tasks. Requirements include a high school diploma, knowledge of Explanation of Benefits, and experience in DME or medical billing. Skills in Microsoft Office, organization, and communication are essential. Salary and hiring details not provided.
Job Description
Claims Resolution Specialist
Posting Details
Posted:
April 15, 2025
Full-Time
Locations
Showing 1 location
Lafayette, LA 70508, USA Job Details
Description
Duties:
Review and understand Insurance policies and standard Explanation of Benefits.
Review and understand medical documentation effectively
Review and resolve Back Collections related tasks, such as
Denial appeals
Payment review and balance billing
Claims generation
Establishes and maintains effective communication and good working relationships with insurance carriers, patients/family, and other internal teams for the patient’s benefit.
Performs other clerical tasks as needed, such as
Answering patient/Insurance calls
Faxing and Emails
Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor
Other responsibilities and projects as assigned.
Requirements:
High School Diploma or equivalent
Knowledge of Explanation of Benefits from insurance companies
General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid
Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
Utilizes initiative while maintaining set levels of productivity with consistent accuracy.
Experience:
3-5 Years in DME or medical billing experience preferred.
Minimum of 1 year of insurance verification or authorizations required.
Skills:
Superior organizational skills.
Proficient in Microsoft Office, including Outlook, Word, and Excel.
Attention to detail and accuracy.
Effective/professional communication skills (written and oral) Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s
