Payer Account Resolution Specialist

This is a fully remote position, open to applicants in Kansas, +1 more state.

📋 Description

• Oversee aging buckets exceeding 30 days for claims that have been submitted but are yet to be adjudicated.

• Engage with insurance companies through payer portals, chat services, or phone calls.

• Keep track of timely filing deadlines.

• Record all activities related to accounts.

• Identify and locate missing remittances and/or payments.

• Address and resolve issues with payers.

• Provide necessary documentation as requested.

• Collaborate with relevant departments to correct claims.

• Escalate complex issues as needed.

• Update any identified registration inaccuracies.

• Recognize opportunities for process improvements.

• Investigate unpaid claims.

• Report identified trends to leadership.

• Maintain accounts receivable days below 40 days.

• Achieve or exceed the organization's cash targets.

• Keep accounts receivable under 90 days to below 25%.

• Perform additional essential duties as assigned.

⛳️ Requirements

• High school diploma or equivalent is required.

• Minimum of 2 years of experience in healthcare billing or revenue cycle.

• Residency in Missouri or Kansas is mandatory.

• Experience with an EHR system (preferably MEDITECH).

• Basic knowledge of CPT, HCPCS, and ICD-10 coding.

• Familiarity with insurance billing procedures.

• Understanding of Explanation of Benefits.

• Strong attention to detail and precision.

• Effective time management skills and ability to adhere to deadlines.

• Excellent organizational abilities.

• Proficient communication skills and ability to work in a team.

• Capability to follow established workflows.

• Must maintain regular and predictable attendance.

• Ability to sit and stand intermittently for 8 to 10 hours daily.

• Competence in using standard office equipment, including a telephone and computer keyboard.

• Ability to perform under pressure while achieving nearly 100% accuracy and adhering to strict deadlines.

• Manual dexterity, near vision, speech, and hearing capabilities required.

• Physical ability to lift or carry up to 40 lbs.

🏝️ Benefits

• Full-time employment.