GENERAL SUMMARY
The Claims Resolution Specialist is responsible for monitoring the charge capture process and identifying issues and process improvement opportunities within the Mid-Revenue Cycle. The position is responsible for revenue leakage root cause analysis and resolution recommendations. This role supports the revenue cycle workflows, charge capture, and work queue processes. This position will help optimize Revenue Cycle by evaluating, validating, and trending data for presentation to all levels of the organization. This role reports to the Coding Supervisor.
ESSENTIAL JOB FUNCTION/COMPETENCIES
CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS
Coding and/or Physician Billing Certification, preferred
KNOWLEDGE | SKILLS | ABILITIES
Demonstrates understanding of business and how actions contribute to company performance
Demonstrates excellent customer service skills
Knowledge of medical terminology, Current Procedural Terminology (CPT), International Classification of Disease (ICD) coding, and the entire revenue cycle process
Knowledge of EHR (Electronic Health Record) software systems and Microsoft Office products
Professional verbal and written communication skills
Ability to develop reports and create presentations
Ability to work collaboratively across disciplines and business lines
Must be comfortable educating staff members
Ability to handle multiple tasks with excellent problem-solving skills
Strong analytical skills with ability to make conclusions and recommendations
Well organized with the ability to maintain accuracy and confidentiality
EDUCATION REQUIREMENTS
High school diploma or general education degree (GED); or equivalent combination of education and experience.
EXPERIENCE REQUIREMENTS
Minimum of one years’ revenue cycle experience within a physician practice
Minimum of one years’ AR experience within a physician practice
Experience in Urology or physician practice environment preferred