Resolution Analyst, Denials

📋 Description

• Review, appeal, and follow up on denied or underpaid claims using EnableComp tools.
• Use payer docs and provider contracts to determine correct reimbursement.
• Review hospital contracts to collect cash from insurers for denied/underpaid claims.
• Gather medical records to prepare underpayment appeals for payer reimbursement.
• Phone follow-ups with payers to confirm documentation and resolve receivables.
• Ensure smooth operations and improved customer satisfaction.

🎯 Requirements

• High School Diploma or GED required.
• Associate's or Bachelor's degree preferred.
• 5+ years in healthcare billing or collections.
• 1+ years client-facing/customer service experience.
• ICD, HCPCS/CPT coding, and medical terminology knowledge.
• Strong MS Office (Word, Excel, Outlook) and basic computer skills.