Account Resolution Specialist 1

Wellstar Health System; Atlanta (GA); Remote; USD 35,000 - 50,000; Full time

Job summary

A leading healthcare organization is seeking an Account Resolution Specialist 1. This entry-level position involves resolving payments from insurance companies, managing appeals, and ensuring optimal communication with various stakeholders. Ideal candidates should possess a high school diploma and strong analytical and communication skills.

Qualifications

• Minimum 2 years collection experience preferred.
• Proficiency with PC applications.

Responsibilities

• Collect and resolve payments from insurance companies.
• Manage denial appeals and ensure insurance payment accuracy.
• Document all payer contact appropriately.

Skills

Strong mathematical skills

Analytical skills

Problem-solving skills

Excellent communication skills

Organizational skills

Education

High school diploma or equivalent

Job description

Join to apply for the Account Resolution Specialist 1 role at Wellstar Health System.

Job Summary

The Account Resolution I representative is responsible for ensuring all eligible accounts are reviewed, appealed, escalated, or adjusted within the designated payer timeframes and are documented appropriately in the patient accounting system. Additionally, the representative will track and report on recovery efforts, utilizing departmental tools, and communicate ongoing issues related to payers, departments, and contracts. The role requires collaboration with team members to ensure timely communication and feedback.

Facility: VIRTUAL-GA

Core Responsibilities and Essential Functions

• Collect and resolve payments from insurance companies, following policies and procedures.
• Manage denial appeals, including receiving, assessing, documenting, tracking, and resolving appeals with third-party payers.
• Research and resolve denied claims, ensuring insurance payment accuracy and processing per contract.
• Prepare and submit reports as required.
• Report ongoing issues to management, providing feedback and process improvement ideas.
• Follow departmental policies for appeals, ensuring proper documentation and communication.
• Identify and communicate contract issues related to denials and delays.
• Transmit documentation to payers to resolve payments.
• Document all payer contact in the appropriate software.
• Ensure claims are processed to secondary insurances and report delays.
• Meet productivity and quality standards in account resolution.

Teamwork

• Contribute to team efforts to achieve AR goals.
• Identify and suggest system and process improvements.
• Cross-train and support team members as needed.
• Encourage collaboration and communication within the team.

Administrative Responsibilities

• Maintain professional communication, ensuring patient privacy and confidentiality.
• Interact professionally with patients, families, payers, physicians, and staff.
• Follow department policies on work schedules and procedures.
• Operate office equipment and report issues.
• Participate in testing and implementation of software applications.
• Perform other duties as assigned, adhering to organizational policies and standards.

Minimum Education and Experience

• High school diploma or equivalent.
• Minimum 2 years collection experience preferred.

Skills

• Strong mathematical, analytical, and problem-solving skills.
• Excellent communication skills, both oral and written.
• Proficiency with PC applications and detail-oriented organizational skills.
• Ability to manage time effectively and adapt to changing priorities.

Additional Information

• Seniority level: Entry level
• Employment type: Full-time
• Industry: Hospitals and Health Care

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