Claims Resolution Specialist

Talent Attraction Specialist - Compassionate Candidate Matchmaker

Employment Type: Contract-to-Hire

Shift: Full-Time, 1st Shift

General Description

LHH Recruitment Solutions is partnering with our client to hire a Claims Resolution Specialist
. This role is critical in ensuring timely and accurate resolution of outstanding medical accounts receivable and insurance claims. The ideal candidate will have strong experience in medical billing and claims follow-up, excellent communication skills, and the ability to work independently in a fast‑paced environment.

• Coordinate workflow for resolving outstanding medical accounts receivable and rejected/pending claims.
• Review and interpret EOB denials and process daily correspondence.
• Request and organize medical records or additional information required by insurance companies.
• Communicate with insurance carriers via web portals, telephone, and fax; prepare appeals and include supporting medical reports.
• Respond to inquiries from insurance companies, patients, and providers.
• Maintain A/R averages and meet key performance indicators including days in A/R, net collection %, non‑contractual write‑offs, and A/R over 120 days.
• Use monthly aging reports to follow up on unpaid claims aged over 30 days.
• Serve as a resource to supervisors and leadership on billing and coding issues (
  CPT-4, HCPCS, LCD/LMRP, ICD-9/10
  ).
• Ensure all work meets required time frames and regulatory guidelines.
• Work assigned queues in the task manager per documented procedures.
• Escalate priority issues to appropriate management and notify leadership of undocumented processes requiring updates.
• Perform other related duties as assigned.

• High school diploma or equivalent.
• Physician/clinical billing certificate preferred, or 2+ years billing/follow‑up experience.

• 2+ years physician/clinical billing or insurance claims follow‑up experience.
• Knowledge of medical terminology preferred.
• Experience with GE Centricity Practice Solutions
  .
• Experience with electronic and paper claims billing and collections.
• Radiology billing experience is a plus.
• Familiarity with payer web portals is a plus.
• Experience with CPT-4, HCPCS, LCD/LMRP, and ICD-9/10
  .
• Strong computer skills, preferably with GE Centricity.

• Current knowledge of HIPAA privacy regulations
  .
• Excellent written and verbal communication skills.
• Ability to work independently and manage assigned tasks.
• Strong attention to detail.
• Ability to manage confidential and sensitive information.

Benefit offerings include medical, dental, vision, life insurance, short‑term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Equal Opportunity Employer/Veterans/Disabled

Cincinnati, OH $46,900.00-$98,000.00 2 weeks ago