Claims Resolution Specialist at Advantia Health

Advantia is seeking a Claims Resolution Specialist to join our team! As a Claims Resolution Specialist, you will be essential in ensuring the accuracy and timeliness of billing and reimbursement for medical services. This important role demands a solid understanding of medical terminology, coding, and billing procedures. This role will report to the RCM Manager.

Job Responsibilities:

• Initiating ERA (electronic remittance advice) set up with clearinghouse and/or third-party portals.
• Initiating EFT (electronic funds transfer) set up with payers & third-party portals.
• Assist in vendor support of daily cash reconciliation duties.
• Clear understanding of RCM Payment Posting Processing (ERA/Manual Posting) of Line-Item Payments/Denials.
• Clear understanding of reconciling offset/recoupment payer remits.
• Call carriers and third parties to resolve unidentified payments/reconcile items.
• Responsible for maintaining payer portal admin and employee registration.
• Assist the RCM Manager with various projects.

Job Requirements:

• High School/GED Education required
• Previous experience in medical billing or a related field is preferred.
• Proficiency in electronic health records and billing software preferred.
• Athena experience required.

Benefits & Compensation:

• Health, Dental, and Vision Insurance
• Health Savings Account (HSA) and Flexible Savings Account (FSA) Option
• 401k Retirement Plan
• Life and Disability Insurances
• Paid holidays/PTO
• Compensation Range: $18.00-$22.00/hr
Please note compensation is based on years of experience.

Please note: Advantia Health provides unparalleled healthcare to our customers by employing the most highly qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination or an approved request for accommodation is required as a condition of employment.

Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.