Claims Resolution Specialist
UHS
Summary
The Claims Resolution Specialist is a pivotal role in ensuring the efficient and accurate processing of healthcare claims. Primary responsibilities will be to analyze and resolve complex claims issues, ensuring timely reimbursement for healthcare services provided. This role demands a deep understanding of healthcare billing and insurance procedures, exceptional attention to detail, and excellent communication skills.
Job description
Qualifications and Requirements
- High School Diploma or GED required. Associates degree preferred.
- Thorough knowledge of CPT, ICD-10 and CDT coding and medical terminology.
- 3+ years' experience in health care claims processing, preferably in a Medicare environment, including customer service experience.
- Ability to plan, organize, maintain priorities and schedules, as well as assure that deadlines are met.
- Certified coder preferred CCA or CCS designation or must be able to obtain certification within one year of employment.
- Excellent verbal and written communication skills.
- Ability to interpret health plan benefits and provider contracts.
- Must be able to deal with difficult customers in a professional manner.
- Ability to interpret and apply established policies and procedures.
- Excellent computer skills which must include working knowledge of Microsoft Office Suite.
- Must be a team player and have the ability to work independently with little supervision.
Requirements
- High School Diploma or GED required
- Associates degree preferred
- Thorough knowledge of CPT, ICD-10 and CDT coding and medical terminology
- 3+ years' experience in health care claims processing, preferably in a Medicare environment, including customer service experience
- Ability to plan, organize, maintain priorities and schedules, as well as assure that deadlines are met
- Certified coder preferred CCA or CCS designation or must be able to obtain certification within one year of employment
- Excellent verbal and written communication skills
- Ability to interpret health plan benefits and provider contracts
- Must be able to deal with difficult customers in a professional manner
- Ability to interpret and apply established policies and procedures
- Excellent computer skills which must include working knowledge of Microsoft Office Suite
- Must be a team player and have the ability to work independently with little supervision
Benefits
- Loan Forgiveness Program
- Competitive Compensation
- Generous Paid Time Off
- Medical, Dental & Vision
- Prescription Drug Plans
- 401(k) Matching
- Discounted Stock Plan
- Student Loan Refinancing
- Career Development
Company overview
Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected providers of hospital and healthcare services, operating as a Fortune 300 corporation headquartered in King of Prussia, Pennsylvania. Founded in 1979, UHS has grown into a major healthcare enterprise with approximately 99,000 employees and annual revenues exceeding $14 billion. The company operates through its subsidiaries, managing 29 acute care hospitals, 331 behavioral health facilities, and 60 outpatient and other facilities across 39 U.S. states, Washington D.C., Puerto Rico, and the United Kingdom. UHS provides comprehensive healthcare services including acute care, behavioral health treatment, cancer centers, and ambulatory surgical centers. The company's strategy focuses on building or acquiring high-quality hospitals in rapidly growing markets and investing in advanced medical equipment and skilled personnel to become the leading healthcare provider in each community it serves. UHS is publicly traded on the New York Stock Exchange (NYSE: UHS) and has established a strong reputation for delivering compassionate, high-quality care while maintaining financial stability and operational excellence.