Resolution Specialist in Charlotte, North Carolina | DiversityInc Careers

Resolution Specialist


This position is responsible for providing high quality client focused service by using knowledge of local, state, and federal program requirements to efficiently maintain and update general applicant information, financial, medical and personal information to support client applications.

• Monitors and fosters ongoing communications with government agencies regarding the status of claims.
• Documents and updates internal database based on daily contact of select members of assigned applicant group and application evidence requirements, i.e. work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required.
• Reviews inbox for daily work queues, identifies missing evidence and follows through to completion.
• Answers incoming calls from internal and external Customers.
• Assists callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process.
• Effectively educates and answers inquiries from patients and family representatives regarding application process.
• Assists clients with scheduling appointments and reminding of appointments, as needed.
• Identifies and takes appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process.
• Diligently follows-up with institutions/businesses resolving issues ultimately affecting application approval.
Identifies appropriate escalation points and works with direct manager to resolve issues.
• Reviews outgoing client material for accuracy prior to submittal.
• Complies with ethics, privacy and compliance policies and procedures.

Education / Training:

• High school diploma required
• College degree preferred but not required

Business Experience:

• Minimum of one-year experience in customer service or administrative duties

• Ability to communicate effectively with different levels of internal and external customers
• Ability to build and maintain positive relationships with customers
• Ability to listen carefully, probe for additional details, and ask targeted questions to gather information
• Strong interpersonal skills
• Strong problem-solving skills and the ability to make good decisions and exercise good judgment
• Ability to adjust positively in a rapidly changing environment
• Strong attention to detail and results driven
• Strong computer skills with working knowledge of Microsoft Office
• Knowledge of hospital software is a plus (e.g., Epic, Cerner, Meditech, Siemens)
• Knowledge of medical terminology is a plus
• Bi-Lingual is preferred
• Ability to work collaboratively within a team