Account Resolution Specialist III - Remote

Overview

As a healthcare revenue cycle business, we manage insurance claims and oversee timely claim resolution and payment processing for our clients. The Accounts Receivable Specialist III is a senior-level role responsible for resolving the more complex, high-dollar, or escalated insurance accounts.

In Short

• Independently manage high-dollar, high volume, and complex accounts.
• Submit accurate medical claims in compliance with requirements.
• Resolve multi-level denials with advanced research.
• Investigate and follow up with payers for account receivables.
• Prepare and submit first- and second-level appeals.
• Execute EHR workflows in systems like Epic and Cerner.
• Review EOBs to resolve discrepancies.
• Analyze discrepancies in payments and take corrective actions.
• Meet productivity benchmarks while maintaining quality standards.
• Stay informed about changes in payer guidelines.

Requirements

• High school diploma or equivalent required.
• CRCR certification or completion required within 90 days.
• Minimum 3 years of experience in medical claim payments.
• Advanced knowledge of ICD-10, CPT/HCPCS, and payer policies.
• Strong negotiation, research, and problem-solving skills.
• Experience with EHR/EMR systems.
• Proficiency in Microsoft Office Suite.

Benefits

• Work from home opportunity.
• Competitive hourly wage.
• Professional development opportunities.
• Health and wellness benefits.
• Supportive team environment.