Account Resolution Specialist II

This is a fully remote position, open to applicants in Arizona, +19 more states.

📋 Description

• Oversee commercial insurance claims from the initial billing to the final resolution and payment processing.

• Conduct status checks and verify eligibility.

• Address claim rejections and resolve denials.

• Prepare and submit first- and second-level appeals along with supporting documentation.

• Follow up with payers and manage assigned insurance accounts receivable.

• Investigate and analyze claim errors and rejections, implementing necessary corrections.

• Stay updated on payer modifications and process changes.

• Assess reasons for non-payment and take appropriate actions to resolve claims.

• Identify and document coding, clinical, and registration issues for referral to relevant teams.

• Escalate stalled claims to payers or Currance leadership when necessary.

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

• Communicate payer-specific issues effectively to the team and management.

• Meet 100% of the daily productivity goal for the project.

• Achieve a monthly quality assurance score of 90% or higher.

• Perform additional duties as assigned to support business requirements.

⛳️ Requirements

• High school diploma or equivalent qualification.

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

• Experience in managing claim follow-ups 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 understanding of ICD-10, CPT/HCPCS, payer guidelines, and the revenue cycle process.

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

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

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

• Understanding of healthcare revenue cycle administration regulations and rules.

• Skill in investigating medical accounts.

• Ability to validate payments.

• Capability to make decisions and take proactive actions.

• Ability to quickly learn collaboration and messaging tools.

• Capacity to work independently and achieve results with minimal supervision.

• Commitment to maintaining accuracy, professionalism, and timeliness in work.

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

🏝️ Benefits

• Option for remote work.

• Flexible remote work schedule aligned with client business hours.

• Criminal background check, employment verification check, and government exclusion check conducted as part of the hiring process.