Claims Resolution Specialist (Hybrid)
Hybrid · Austin, Texas, United States
Job Summary
Claims Resolution Specialist (Hybrid) processes follow-up actions on denied claims based on ANSI reason codes and payer policies, uses Epic In-Basket to obtain authorization and edit claim data, reviews procedure/diagnosis codes for compliance, researches payor denials, submits appeals when appropriate, updates account notes, posts adjustments, and communicates with management on unresolved issues. Requires healthcare experience, familiarity with ANSI codes, Epic, and strong Excel/office skills; works a Monday–Friday hybrid schedule in Austin, TX.
Required Qualifications
- High school diploma or GED
- Two (2) or more years of experience working in a healthcare setting (medical office, Revenue Cycle, etc.)
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