Claims Resolution Specialist

Full-time

Remote - Camp Hill, PA

Ambulatory Health Care Services

About the position

The Claims Resolution Specialist at Select Medical is responsible for investigating and resolving outstanding insurance claims to ensure that patients are not adversely affected. This role involves a combination of research, communication, and follow-up to manage accounts effectively. The position offers a full-time schedule with the possibility of a hybrid work arrangement after a probationary period, and it emphasizes a supportive work environment with opportunities for advancement.

Responsibilities

• Investigate and follow-up on all open balances for accounts that have received a payment or denial, or that are greater than 30 days from billing.
• Contact responsible party to establish reason for non-payment and document all verbal and written communication in the system.
• Maintain consistent, productive, and timely follow-up on accounts, ensuring no time between follow-ups exceeds 30 days.
• Maintain a productivity of 20 to 25 accounts per day, subject to operational needs.
• Make outgoing calls to patients, insurance companies, and attorneys regarding claim status to reduce outstanding receivables.
• Regularly communicate with hospital staff and department management on accounts receivable issues and problematic payor trends.
• Identify and resolve issues impacting the timely collection of open receivables.
• Request account adjustments as necessary via write-off and refund requests.
• Notify database operations of changes or additions to specific payor, plan, contract, address, or other pertinent information.
• Meet productivity and collections targets set by management.
• Perform other duties or special projects as assigned.

Requirements

• High School Diploma or Equivalent
• One year of experience in medical billing, medical collecting, or claims processing (2+ years for remote candidates).

Nice-to-haves

• Computer Skills
• Proficiency in Microsoft Office: Outlook and Excel
• Ability to work with multiple programs simultaneously
• Good interpersonal, oral and written communication skills
• Previous experience in a metrics-based role
• Time management and organizational skills
• Proven experience with investigative research
• Ability to work independently and as part of a team
• Attention to detail
• Flexibility and openness to change

Benefits

• Paid Time Off (PTO) and Extended Illness Days (EID)
• Health, Dental, and Vision Insurance
• Life insurance
• Prescription coverage
• 401(k) retirement plan with company match
• No Required Weekends