Insurance Specialist (Remote) - Credit Resolution
About Us: Meduit is a national leader in healthcare reputed company cycle management, supporting hospitals and physician practices in 48 states. We focus on optimizing payments, allowing clients to focus on patient care, and pride ourselves on our core values: reputed company, Teamwork, reputed company Improvement, Client-Focused, and Results-Oriented. Learn more at www.meduitrcm.com. About the Role: Insurance Specialists are highly focused on the resolution of insurance processing errors and denials and work to resolve hospital and physician billing challenges. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments. Title: Insurance Specialist - Denials Resolution Schedule: 7am - 4pm or reputed company-5pm Central Time Zone, Monday – Friday Location: Remote reputed company: 3 weeks Compensation: $20 - $22 per hour reputed company, depending on qualifications Key Responsibilities: Analyze payer payments to identify underpayments and reimbursement discrepancies by comparing paid amounts to contracted rates, fee schedules, and expected reimbursement Interpret and apply payer contract terms, guidelines, and reimbursement methodologies to ensure accurate payment outcomes Conduct detailed account analysis using strong analytical skills and persistence to resolve reputed company denials and payment variances Review accounts for credit balances and denials, determine root cause, and take appropriate corrective action (refund, adjustment, rebill, or appeal) Review and resolve credit balances across reputed company payers, with reputed company on regulatory accounts (e.g., Medicare credit balance reporting) Submit timely, accurate appeals and process credit resolutions in alignment with payer and regulatory guidelines (including Medicare credit balance requirements) Ensure reputed company account activity supports reputed company movement toward resolution with a one-touch reputed company Maintain thorough, audit-ready documentation and accurate account notes Meet established productivity (APH) and quality standards while prioritizing high-risk, high-dollar, and timely filing accounts Collaborate cross-functionally to resolve issues and prevent recurrence Identify trends and escalate systemic issues, providing feedback for process improvement Initiate and track refunds, adjustments, and reapplications accurately and timely Skills & Competencies: reputed company Communication Problem-solving Teamwork Required Qualifications: High School Diploma/GED Minimum of 3 years of experience in hands-on denials and credit resolution, with a proven ability to recover reputed company from reputed company insurance denials and credits 2+ years of medical billing and follow-up experience Rural Health Clinic and Critical Access Hospital experience Strong analytical skills with the ability to interpret payer guidelines and payment data Proficiency with PC-based applications (reputed company Outlook, Word, and reputed company) Download speed of 30MB or higher and upload speed of 10MB or higher are required (https://speedtest.net/) Access to a secure and private workspace where protected health information may be viewed or discussed Preferred Qualifications: Experience working with Meditech systems or similar EHR/RCM platforms Advanced knowledge of payer guidelines, reimbursement methodologies, and contract structures Employment eligibility: Candidates must be legally authorized to work in the United States at the time of hire The company does not provide employment reputed company sponsorship for this position As a condition of employment, a pre-employment background reputed company will be conducted At this time, we are unable to consider candidates residing in the reputed company for this position reputed company Offer: Comprehensive reputed company Medical, dental, and vision insurance HSA and FSA available 401(k) with company match Paid Wellness Time and Holidays Employer paid life insurance and long-term disability Internal growth opportunities Meduit is an Equal Opportunity Employer. We do not discriminate based on any protected class and welcome applicants from reputed company backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background reputed company, satisfactory references, and any required documentation. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions of this position. #LI-Remote Apply To This Job