About SHERLOQ Solutions
Established in 1916, SHERLOQ began as a member-owned cooperative in Tampa, Florida. The founding mission was to facilitate the sharing of credit information, promote the equitable principles in trade, and give back to the community. Over 100 years later, SHERLOQ continues as a company serving hospitals, healthcare systems, physician practices, and utilities nationwide.
This role focuses on communication between healthcare providers and health insurance payers to expedite claim resolution.
The position is responsible for resolving healthcare claims through verbal or online inquiries, navigating provider systems and payer websites, verifying patient and insurance information, researching eligibility and coordination of benefits, analyzing payer denials, supporting appeals, tracking underpayments and coding-related denials, and researching missing payments.
Qualifications
- High school diploma or equivalent required
- 3 years of healthcare industry experience required
- 1 year of healthcare claims billing, insurance collections, coding, or denials management required
- Specific payer experience may be required, such as Medicare or state-specific payers
- Ability to obtain HFMA CRCR or AAHAM CRCS accreditation within two years and maintain it in good standing
- Excellent verbal and written communication skills
- Strong interpersonal and negotiation skills
- Organized with attention to detail
- Ability to read and interpret explanation of benefits
- Critical thinking and problem-solving skills
- Proficiency with Microsoft 365 tools, including Teams, Outlook, OneDrive, and SharePoint, in a cloud-based collaborative environment
Benefits
- Medical insurance
- 401(k)
- Paid time off
- Paid holidays
- Tuition reimbursement
- Additional supplemental benefits
Location
Tampa, Florida, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago