Account Resolution Specialist II

This is a fully remote position, open to applicants in Arizona, +20 more states.

📋 Description

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

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

• Investigate and analyze claim errors and rejections.

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

• Keep track of payer updates and changes in processes.

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

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

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

• Escalate stalled claims to payers or Currance leadership.

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

• Recognize payer-specific issues and communicate them to the team and management.

• Perform additional duties as assigned to meet business needs.

• Achieve 100% of the project daily goals.

• Maintain a 90% monthly quality assurance score.

• Manage accounts receivable from claim billing through to final resolution across both government and commercial payer portfolios.

⛳️ Requirements

• High school diploma or equivalent is required.

• A minimum of 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.

• Proficiency 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.

• Ability to validate payments.

• Capacity to make decisions and take action.

• Quick learning ability for collaboration and messaging tools.

• Ability to work independently and achieve results with minimal oversight.

• Candidates must pass criminal background checks, employment verification, and mandatory government exclusion checks as a condition of employment or engagement.

🏝️ Benefits

• Remote work opportunities.

• Team coverage hours from 7:30 AM to 7:30 PM CST.

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