✨ AI Summary
The Reconciliation Specialist will be responsible for daily reconciliation activities, resolving claim rejections, and preparing claim resubmissions and reconciliation reports. This role involves collaboration with Claims Audit, Billing, Coding, and Clinical teams, as well as monitoring reconciliation performance to ensure compliance with payer contracts and hospital policies. The position requires a Bachelor’s degree in medicine, Pharmacy, or Dentistry, 1-3 years of experience in Claims Auditing, and previous hospital experience.
Requirements
Bachelor’s degree in medicine, Pharmacy, or Dentistry.1–3 years of experience in Claims Auditing.Previous hospital experience is required.Good knowledge of Revenue Cycle Management (RCM), medical claims, insurance contracts, and claim resubmission processes.Strong analytical, communication, and reporting skills.
Description
Perform daily reconciliation activities and resolve claim rejections.Prepare claim resubmissions and reconciliation reports.Collaborate with Claims Audit, Billing, Coding, and Clinical teams.Monitor reconciliation performance and ensure compliance with payer contracts and hospital policies.