Account Resolution Specialist II

This is a fully remote position, open to applicants in Arizona, +21 more states.

📋 Description

• Submit medical claims in accordance with federal, state, and payer-specific regulations.

• Review and rectify claim edits, errors, and denials to guarantee accurate payments.

• Investigate and analyze claim errors and rejections.

• Follow up with payers to collect on assigned insurance accounts receivable.

• Monitor updates from payers and adjust processes accordingly.

• Assess reasons for non-payment and resolve client claims effectively.

• Prepare and submit first- and second-level appeals, including necessary documentation.

• Identify and document issues related to coding, clinical data, and registration for referral and correction.

• Escalate stalled claims to payers or leadership at Currance.

• Verify and adjust claims to ensure client accounts accurately reflect their liability and balances.

• Identify payer-specific concerns and communicate them to the team and management.

• Perform additional duties as assigned to meet business needs.

• Achieve 100% of the daily productivity goals for projects.

• Attain a 90% monthly quality assurance score.

⛳️ Requirements

• High school diploma or its equivalent.

• At least 2 years of experience in securing medical claim payments from health insurance companies.

• Experience in managing claim follow-up and appealing denied claims with healthcare vendors or providers.

• Familiarity with EMR/EHR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms.

• Strong working knowledge of ICD-10, CPT/HCPCS, payer guidelines, and the revenue cycle process.

• Excellent written and verbal communication skills, with the ability to effectively advocate with payers.

• Proficient in Microsoft Office Suite, Teams, and various desktop applications.

• Understanding of basic coding principles and payer-specific billing requirements.

• Knowledge of healthcare revenue cycle administration regulations and compliance rules.

• Capability to investigate medical accounts and validate payments.

• Ability to make decisions, take action, learn collaboration and messaging tools, work independently, and achieve results with minimal supervision.

• Subject to criminal background checks, employment verification, and mandatory government exclusion checks as a condition of employment or engagement.

• Availability to work CST hours; preferred shifts are from 7:00 AM to 3:30 PM CST or 8:00 AM to 4:30 PM CST.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with company matching.

• Opportunities for professional development and continuing education.

• Flexible working hours and remote work options.

• Paid time off and holiday pay.