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Claims Resolution Coordinator

fully flexible

Remote:

Full Remote

Contract:

Full time

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

High school diploma or equivalent, Minimum 2 years with Athena billing platform, 3+ years in Physician billing environment, Advanced knowledge of claims and A/R workflows, Intermediate proficiency in MS Office and Google Suite.

Key responsabilities:

Review and clear front-end claims holds
Address root causes for payer denials
Conduct AR follow-up on aged claims
Prepare patient refunds and answer inquiries
Support quality patient care and satisfaction

CopilotIQ SME https://copilotiq.com/

51 - 200 Employees

See more CopilotIQ offers

Job description

CopilotIQ is perhaps the most exciting company at the intersection of technology and healthcare. CopilotIQ is transforming care for seniors with chronic conditions including diabetes and high blood pressure. Our vision is to add five great years to the lives of a million members, by transforming how we care for chronic conditions including diabetes and hypertension. Much like a pilot has a computer and person sitting next to them to ensure they stay safe, we believe every patient deserves to have someone watching over them and ensuring they are healthy.

What is the Claims Resolution Coordinator role?

As a Claims Resolution Coordinator at CoPilotIQ, you'll play a crucial role in ensuring efficient healthcare claims processing. Your responsibilities include daily review and resolution of front-end claims holds and payer denials, addressing root causes to optimize submission and reimbursement. This role demands a proactive, detail-oriented professional, essential for achieving CoPilotIQ's revenue cycle management success through your dedication to high standards of efficiency and compliance.

What you’ll be doing:

Daily review and clearing of assigned front end claims holds and backend payer denials
Identify and address claim hold and payer denial root causes
Conduct AR follow-up of aged claims by contacting insurance company to ensure timely payment
Ensure patient account information for accuracy including patient demographics, insurance information and billing guidelines
Initiate appeals as necessary
Act on correspondence received via billing system, email or fax
Respond to internal and external billing inquiries
Prepare refunds to insurance payers and patients
Answer patient questions, provide information about billing related issues, and resolve patient complaints
Review and recommend accounts for transfer to 3rd party collection and/or bad debt write-off
Other duties as assigned that support the goals and objective of CoPilotIQ in their effort to provide quality patient care and platinum level patient satisfaction
Perform other assignments as directed

What you’ll bring

High school diploma or equivalent
Minimum of 2 years of documented experience and acuity on the Athena billing platform
3 + year’s experience in a Physician billing environment.
Advanced knowledge of claim content and submission requirements
Complete understanding of A/R and overall Revenue Cycle workflows
Working knowledge of CPT, ICD-10 coding and modifier application along with understanding medical terminology
Intermediate knowledge of MS Office, Word and Excel; Google Suite Products
Skill in organizational techniques including time management, prioritization, multitasking and problem solving
Exceptional interpersonal communication skills required
Ability to read, understand and follow oral and written instructions
Ability to establish and maintain effective working relationships with patients, physicians, other clinical staff and the public
Ability to work under pressure in a fast-paced environment