Revenue Cycle Coverage and Claims Associate II

Overview

Revenue Cycle Coverage and Claims Associate II within Abbott Cancer Diagnostics, supporting accurate and timely insurance reimbursement by independently resolving complex eligibility, claim, denial, and payment issues.

What you'll do

• Independently verify patient insurance eligibility and coverage, research discrepancies, and update demographics, financial information, and guarantor details.
• Review, edit, and submit claims and appeals; correct rejected claims from claim scrubbers, clearinghouses, or payers; and provide supporting documentation as needed.
• Analyze denials, underpayments, unpaid aging claims, and reimbursement issues using federal, state, payer, and internal guidelines to determine appropriate next steps.
• Manage complex claim escalations, bulk projects, claim edit and follow-up work queues, CRM support, and workflow validation related to new products or process changes.
• Document actions accurately, maintain HIPAA confidentiality, meet quality and turnaround standards, and partner with internal teams and payers to drive timely claim resolution.
• Use Epic, payer portals, clearinghouse tools, and other systems to manage escalations, maintain accurate account information, and help move claims toward resolution.

What you'll need

• High School Diploma or General Education Degree (GED).
• One (1) or more years of experience in a revenue cycle role and three (3) or more years of experience in medical billing, claims, and/or insurance processing.
• Extensive and current knowledge of government, managed care, and commercial insurance claim submission requirements, reimbursement guidelines, and denial reason codes.
• Knowledge of medical terminology, health insurance terminology, and electronic health record (EHR) systems.
• Proficiency with computer systems and keyboarding, with strong attention to detail, organization, problem-solving, and quality output.
• Ability to work independently and collaboratively in a changing environment while communicating professionally with payers, clients, and internal teams.
• Ability to work Monday through Friday during normal business hours aligned to 8:00 a.m.-5:00 p.m. CST.
• Authorization to work in the United States without sponsorship.

Nice to have

• Related Associate's degree or medical billing certification.
• Five (5) or more years of experience in the medical or insurance billing field.
• Experience with Epic or another electronic health record (EHR) application.

Details

• Location: United States of America, Remote.
• Working hours: Monday through Friday, 8:00 a.m.-5:00 p.m. CST; standard work shift.
• Base pay: $17.00 – $34.00/hour; pay may vary in specific locations.
• No travel required.
• Significant work activities: continuous sitting for more than 2 consecutive hours in an 8-hour day; keyboard use for 50% or more of the workday.