Healthcare Claims Resolution Expert

Providers; Reno (NV); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Loan forgiveness

Excellent health plans

401K with company match

Job summary

Prominence Health seeks a Claims Resolution Specialist to ensure accurate processing of healthcare claims and timely reimbursement. This pivotal role requires strong analytical skills, attention to detail and effective communication with providers and members.

You will work within the Prominence Health claims team, applying CPT/ICD-10/CDT coding knowledge and billing procedures to resolve complex issues and improve overall claim outcomes.

Qualifications

• Excellent verbal and written communication skills.
• Ability to interpret health plan benefits and provider contracts.
• Experience in health care claims processing and customer service.

Responsibilities

• Analyze and resolve complex claims issues to ensure timely reimbursement.
• Ensure claims are processed accurately and efficiently.
• Maintain up-to-date knowledge of healthcare billing procedures and coding requirements.

Skills

Verbal communication

Written communication

Customer service

Problem solving

Education

High School Diploma or GED

Associates degree preferred

Tools

Microsoft Office

Job description

Prominence Health seeks a Claims Resolution Specialist to ensure accurate processing of healthcare claims and timely reimbursement. This pivotal role requires strong analytical skills, attention to detail and effective communication with providers and members.

You will work within the Prominence Health claims team, applying CPT/ICD-10/CDT coding knowledge and billing procedures to resolve complex issues and improve overall claim outcomes.