Full-Time Sr. Medical Claims Billing Specialist

• Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring.
• Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
• Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.
• Collaborate internal teams (Performance, Operations, Sales) as well as care center staff when appropriate.
• Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements.
• Performs Denial analysis utilizing the Trizetto platform.
• Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality

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