Insurance Specialist – Credit Resolution

🔥 3 minutes ago

❄️ Minnesota – Remote

❄️ Minnesota – Remote

💵 $20 - $22 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

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Meduit | Driving Revenue Cycle Performance

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

⚕️ Healthcare Insurance

🤖 Artificial Intelligence

☁️ SaaS

Healthcare Insurance • Artificial Intelligence • SaaS

Meduit | Driving Revenue Cycle Performance is a technology-driven healthcare revenue cycle management (RCM) company that combines RCM expertise with AI, robotic process automation, predictive analytics and patient engagement tools to optimize cash flow, reduce denials, and improve patient satisfaction for hospitals, health systems and large practices. Their services include pre-service solutions, centralized pre-registration, patient financing, business office services, denials resolution, billing & follow-up, legacy A/R work down, government reimbursement services, and AI offerings such as MeduitAI™, SARA conversational and robotic automation, automated pre-authorization and claims follow-up. Meduit also provides consulting, reporting & analytics, staffing, specialized recoveries and comprehensive business office services to help providers accelerate revenue and mitigate operational challenges.

📋 Description

• Analyze payer payments to identify underpayments and reimbursement discrepancies by comparing paid amounts to contracted rates, fee schedules, and expected reimbursement • Interpret and apply payer contract terms, guidelines, and reimbursement methodologies to ensure accurate payment outcomes • Conduct detailed account analysis using strong analytical skills and persistence to resolve complex denials and payment variances • Review accounts for credit balances and denials, determine root cause, and take appropriate corrective action (refund, adjustment, rebill, or appeal) • Review and resolve credit balances across all payers, with priority on regulatory accounts (e.g., Medicare credit balance reporting) • Submit timely, accurate appeals and process credit resolutions in alignment with payer and regulatory guidelines (including Medicare credit balance requirements) • Ensure all account activity supports forward movement toward resolution with a one-touch mindset • Maintain thorough, audit-ready documentation and accurate account notes • Meet established productivity (APH) and quality standards while prioritizing high-risk, high-dollar, and timely filing accounts • Collaborate cross-functionally to resolve issues and prevent recurrence • Identify trends and escalate systemic issues, providing feedback for process improvement • Initiate and track refunds, adjustments, and reapplications accurately and timely

🎯 Requirements

• High School Diploma/GED • Minimum of 3 years of experience in hands-on denials and credit resolution, with a proven ability to recover revenue from complex insurance denials and credits • 2+ years of medical billing and follow-up experience • Rural Health Clinic and Critical Access Hospital experience • Strong analytical skills with the ability to interpret payer guidelines and payment data • Proficiency with PC-based applications (Microsoft Outlook, Word, and Excel) • Download speed of 30MB or higher and upload speed of 10MB or higher are required • Access to a secure and private workspace where protected health information may be viewed or discussed

🏖️ Benefits

• Comprehensive paid training • Medical, dental, and vision insurance • HSA and FSA available • 401(k) with company match • Paid Wellness Time and Holidays • Employer paid life insurance and long-term disability • Internal growth opportunities