Healthcare Claims Denials Specialist - Remote

Overview

Become a part of our caring community and help us put health first. As an RCM Healthcare Claims Denials Specialist/Accounts Receivable Specialist, you will ensure the coordination of claim activities and designated agencies, and the timely reimbursement of receivables.

In Short

• Ensure timely reimbursement of receivables.
• Research and resolve claims that have not passed payer edits.
• Determine action to resolve rejected invoices.
• Analyze outstanding monthly accounts receivable.
• Clear payment variances and initiate corrective action.
• Guide and support agency personnel in claims processing.
• Prepare input data forms for the computer system.
• Educate agencies about expectations for clean claims.
• Work from a dedicated space protecting member PHI/HIPAA information.
• Occasional travel to Humana's offices for training or meetings.

Requirements

• High School Diploma or equivalent.
• Minimum of two years medical claims processing experience preferred.
• Knowledge of healthcare collection procedures preferred.
• Effective analytical and communication skills.

Benefits

• Health benefits effective day 1.
• Paid time off, holidays, and jury duty pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance and scholarships for eligible dependents.
• Career development opportunities.