
Billing Claims Expert
3 days ago
We are seeking experienced and skilled professionals to manage and resolve Out-of-Network claims after initial submission.
- Key Responsibilities:
- Resolve OON claims post-submission, including denials and underpayments, through detailed analysis and effective communication with various stakeholders.
- Collaborate with insurance companies, healthcare providers, and patients to address OON issues efficiently.
- Evaluate and process claims accurately, ensuring timely eligibility verification and benefit coordination.
- Monitor and report OON claim status in a proactive manner.
- Stay updated on new payers, policies, and industry developments affecting OON claims.
Qualifications:
- Proven experience in resolving OON claims, focusing on post-submission challenges.
- Strong knowledge of insurance processes, OON billing guidelines, and emerging payer policies.
- Excellent communication, problem-solving, and organizational skills to drive results.
- Proficiency in Excel for data analysis and processing.
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