Healthcare Claims Resolution Expert

Prominence Health; Reno (NV); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Challenging and rewarding work environ

Competitive Compensation & Generous P0

Excellent Medical, Dental, Vision and

401(K) with company match and discount

SoFi Student Loan Refinancing Program

Career development opportunities with

Benefits Guest Website

Job summary

Prominence Health is seeking a Claims Resolution Specialist to ensure accurate processing of healthcare claims and timely reimbursements. The role requires deep knowledge of CPT, ICD-10, CDT coding and strong attention to detail.

You will analyze complex claims, communicate with providers and members, and contribute to optimized billing procedures within a value-based care framework. UHS affiliation enhances career growth and benefits.

Qualifications

• Thorough knowledge of CPT, ICD-10 and CDT coding.
• 3+ years’ experience in health care claims processing.
• Excellent verbal and written communication skills.
• Ability to interpret health plan benefits and provider contracts.
• Must be a team player and able to work independently.
• Certification: CCA or CCS preferred or obtainable within 1 year.

Responsibilities

• Analyze and resolve complex healthcare claims issues.
• Ensure timely reimbursement for healthcare services.
• Process claims accurately and efficiently.
• Communicate effectively with providers and members.

Skills

CPT coding

ICD-10 coding

CDT coding

Medical terminology

Customer service

Communication skills

Team player

Education

High School Diploma or GED

Associates degree

Tools

Microsoft Office Suite

Job description

Prominence Health is seeking a Claims Resolution Specialist to ensure accurate processing of healthcare claims and timely reimbursements. The role requires deep knowledge of CPT, ICD-10, CDT coding and strong attention to detail.

You will analyze complex claims, communicate with providers and members, and contribute to optimized billing procedures within a value-based care framework. UHS affiliation enhances career growth and benefits.