Account Resolution Specialist II

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

📋 Description

• Oversee a large volume of inpatient and outpatient accounts for a prominent pediatric hospital system and its affiliated physician practices.

• Address insurance denials and manage first- and second-level appeals with appropriate documentation.

• Follow up on claims and collect assigned accounts receivable from insurance providers.

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

• Review and rectify claim edits, errors, and denials.

• Investigate claim discrepancies and rejections, implementing necessary corrections.

• Keep updated on payer modifications and process changes.

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

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

• Escalate delayed claims to payers or Currance leadership as needed.

• Verify and amend claims to ensure client accounts reflect accurate liabilities and balances.

• Recognize payer-specific issues and relay them to the team and manager.

• Meet 100% of the project's daily goals while achieving a 90% monthly quality assurance rating.

• Perform additional duties as assigned to support business needs.

⛳️ Requirements

• High school diploma or equivalent qualification.

• 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 advocate effectively with payers.

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

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

• Knowledge of regulations and rules pertaining to Healthcare Revenue Cycle administration.

• Skilled in investigating medical accounts.

• Capable of validating payments.

• Ability to make informed decisions and take appropriate action.

• Quick to learn and utilize collaboration and messaging tools.

• Capable of working independently and achieving results with minimal oversight.

• Must pass criminal background checks, employment verification, and government exclusion screening requirements.

🏝️ Benefits

• Remote work opportunity.

• Monday–Friday, 6:00 AM–2:30 PM MST schedule.

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