Strategic Claims Resolution Specialist

Omaha Tribe of Nebraska; Macy (NE); On-site; USD 42,000 - 68,000; Full time

Job summary

Omaha Tribe of Nebraska is seeking a Revenue Cycle Specialist to research, correct, resubmit, and resolve rejected or denied medical claims. You will coordinate with billing staff, providers, and payers to ensure proper reimbursement for services at the Health Center.

Responsibilities include monitoring electronic clearinghouse rejections, researching denial codes, preparing corrected claims and appeals, and maintaining detailed documentation while safeguarding patient privacy per HIPAA and

Qualifications

• AA degree or 2+ years in medical billing, healthcare administration, or related field.
• Research billing issues, follow procedures, and perform corrective actions.
• Strong attention to detail, good organization, and deadline discipline.
• Familiarity with ICD-10-CM, CPT, and HCPCS coding concepts.
• Experience with electronic clearinghouses, payer portals, and claims processing.
• Medical billing/coding certification preferred but not required.

Responsibilities

• Monitor rejected claims and submission errors; take corrective actions.
• Review denials, correct information, and resubmit or appeal as needed.
• Coordinate with billing techs, providers, and payers to obtain missing data.
• Maintain documentation of rejection reasons and outcomes.
• Protect patient privacy and comply with HIPAA and Health Center policies.

Skills

Claim research

Denial resolution

Communication

Organization

Attention to detail

HIPAA compliance

Education

AA degree or 2+ years

Tools

Microsoft Word

Excel

Billing systems

Job description

Omaha Tribe of Nebraska is seeking a Revenue Cycle Specialist to research, correct, resubmit, and resolve rejected or denied medical claims. You will coordinate with billing staff, providers, and payers to ensure proper reimbursement for services at the Health Center.

Responsibilities include monitoring electronic clearinghouse rejections, researching denial codes, preparing corrected claims and appeals, and maintaining detailed documentation while safeguarding patient privacy per HIPAA and