Remote Claims Resolution Specialist I

Penn Medicine, University of Pennsylvania Health System; Philadelphia (Philadelphia County); On-site; USD 42,000 - 62,000; Full time

Job summary

Penn Medicine is seeking an Accounts Resolution Specialist I to support the RAD-O-BRO Data A/R team from a fully remote location. The role focuses on researching patient accounts, resolving claim edits, and following up on denied or underpaid claims with insurers.

You will investigate denials, escalate trends, and assist in reprocessing to maximize first-pass resolutions. Requires strong billing knowledge and 3+ years of healthcare experience.

Qualifications

• Education or experience in health care billing demonstrated by a minimum of 3 years.
• Knowledge of Medicare/Medicaid guidelines and payer policies.
• Ability to investigate denials and coordinate appeals.

Responsibilities

• Research patient accounts in claim edit and follow-up queues.
• Identify untimely accounts and perform write-offs per policy.
• Maintain billing standards per payer guidelines; respond to inquiries.
• Meet or exceed productivity and quality targets set by supervisor.

Skills

Billing knowledge

Insurance denials research

Patient account research

Education

High School diploma or GED

Job description

Penn Medicine is seeking an Accounts Resolution Specialist I to support the RAD-O-BRO Data A/R team from a fully remote location. The role focuses on researching patient accounts, resolving claim edits, and following up on denied or underpaid claims with insurers.

You will investigate denials, escalate trends, and assist in reprocessing to maximize first-pass resolutions. Requires strong billing knowledge and 3+ years of healthcare experience.