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Resolution Specialist

Location: Atlanta, GA, United States
Job # 10938493
Date Posted: 05-09-2018
Title: Resolution Specialist 
Location: Atlanta, GA
Duration: Contract-to-hire
M-F 9am - 5pm
Pay rate: $18 

Our client, an industry-leading healthcare information technology company, is seeking a Resolutions Specialist for their Atlanta office.  This role is open due to the robust growth of our client’s business.  The current department has 35 on staff with 3 supervisors and they are looking to grow the team to over 45 staff members in the next month.
The ideal candidate will have a confident phone presence to make 30 outbound calls a day to receive claim information with strong problem-solving skills, as every new claim can have their own unique challenges.  It is imperative for candidates to have Property and Casualty (Auto Insurance, Workers’ Compensation) experience.

  • Responsible for investigating, billing and collecting on hospital claims from Property & Casualty insurance carriers
  • Communicate with patients, insurance adjusters, and attorneys to resolve claims
  • Initiate outbound calls to patients to complete accident interviews via telephone
  • Investigate and confirm any medical coverage related to auto, general liability, and/or worker compensation insurance available to the patient, updating the patient file in the system
  • Contact Auto/Work Comp insurance carriers and attorneys via telephone to identify available accident insurance coverage for the patient
  • Responsible for verifying patient’s eligibility for coverage and obtain billing contact information for the insurance adjuster and/or attorney
  • Follow up for with and send correspondence to insurance carriers and attorneys for expedited resolution and payment on patient’s account
  • Request documentation where applicable or payment and account status from insurance adjuster or attorney
  • File Hospital Liens and assist in settlement negotiation between the hospital and patient’s attorney/insurance adjuster
  • Maintain proper account documentation 
  • Complete account documentation and return account to the hospital once claim has been resolved
  • Bachelors degree preferred
  • Minimum of one-year revenue cycle (ex: insurance billing, collections) experience
  • Property and Casualty (Auto Insurance, Workers’ Compensation) experience preferred
  • Health Insurance Appeals experience preferred
  • Subrogation and Coordination of Benefits experience preferred

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