Account Resolution Specialist III

Currance; Irvine (CA); Remote; USD 85,000 - 120,000; Full time

Job summary

Currance, Inc. is seeking an experienced Accounts Receivable Specialist III to manage complex hospital billing accounts across major commercial and government payers. The role emphasizes payer knowledge, accuracy, and independent work to meet productivity and quality goals.

Join a team supporting CST-based hospitals, using MedHost and multiple payer portals. This senior position requires 3+ years in medical claims, strong ICD-10/CPT/HCPCS knowledge, and proficiency with EHR/EMR systems such as

Qualifications

• High school diploma or equivalent; Associate's degree preferred.
• CRCR certification or completion within 90 days of hire.
• Minimum 3 years of experience securing medical claim payments and managing denials.
• Advanced knowledge of ICD-10, CPT/HCPCS, payer policies, and reimbursement regulations.
• Experience using EHR/EMR systems (Meditech, Epic, Cerner, Allscripts, Nextgen or similar).
• Proficiency with Microsoft Office Suite and collaboration tools (Teams).

Responsibilities

• Independently manage high-dollar, high-volume, and complex accounts with significant financial impact.
• Submit accurate medical claims per federal, state, and payer guidelines.
• Resolve multi-level denials with advanced research and payer escalation.
• Investigate and follow up with payers to collect AR.
• Prepare and submit first- and second-level appeals with supporting documentation.
• Oversee EHR workflows and reroutes across Epic, Cerner, Meditech, Allscripts.
• Review EOBs to resolve discrepancies and underpayments.
• Complete rebills and corrections to maximize reimbursement.
• Stay informed about payer guideline changes and trends.

Skills

CRCR certification

ICD-10 knowledge

CPT/HCPCS knowledge

Payer policies knowledge

Negotiation skills

Research skills

Problem-solving

EHR/EMR experience

Microsoft Office/Teams

Education

High school diploma or equivalent

Associate's degree preferred

Tools

Meditech

Epic

Cerner

Allscripts

Nextgen

Job description

Description: We are hiring in the following states: AR, AZ, CA, CO, FL, GA, IA, IL, LA, MO, MT, NC, NE, NJ, NV, OH, OK, PA, SD, TN, TX, VA, WA, and WI This is a remote position.

Job 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. ARSIIIs are recognized for their payer knowledge, accuracy, and ability to consistently deliver exceptional results. ARSIIIs are expected to set the standard for quality, productivity, and professionalism, serving as an example for the rest of the team. This role requires strong analytical skills, expert understanding of payer rules, and the ability to work independently while meeting productivity and quality goals.

Client Environment & Role Focus – Commercial and Government ARS III

Join a team supporting an CST based Hospital, utilizing MedHost as the primary host system along with Artiva, and multiple payer portals (including Availity).

This position focuses on Hospital Billing (HB) accounts with a mix of major commercial payers (BlueCross, Cigna, Aetna, UnitedHealthcare) and government payers (Medicare and Medicaid).

Job Duties And Responsibilities

• Independently manage high-dollar, high volume, and complex accounts with significant financial impact.
• Submit accurate medical claims in compliance with federal, state, and payer-specific requirements.
• Resolve multi-level denials that require advanced research, payer escalation, and detailed follow-up.
• Investigate and follow up with payers to collect insurance accounts receivables.
• Prepare and submit first- and second-level appeals with complete supporting documentation, ensuring thorough tracking and follow-up to maximize reimbursement.
• Execute and oversee EHR workflows in systems such as Epic, Cerner, Meditech, and Allscripts, including reroutes, denial closures, and account adjustments.
• Review Explanation of Benefits (EOBs) to resolve payment discrepancies, claim denials, and contractual underpayments.
• Complete rebills and corrections to maximize reimbursement.
• Transforming revenue cycle differently.
• Improving healthcare together.
• Analyze discrepancies in payments and take corrective actions as needed.
• Meet productivity benchmarks while maintaining high-quality standards.
• Research, analyze, and correct errors and rejections, identify root causes, and implement preventive solutions.
• Verify and adjust claims to ensure accurate client liability and account balance.
• Stay informed about changes in payer guidelines and processes for accurate claim submissions.
• Identify payer trends impacting reimbursement and bring findings to management for review.
• Participate in daily shift briefings and contribute as needed.
• Productivity: Achieve 125% of the project daily goal.
• Quality: Achieve 95% monthly quality assurance score.
• Other expectations: As outlined by the department.

Requirements

Qualifications:

• High school diploma or equivalent required; Associate's degree preferred
• CRCR certification or completion of certification required within 90 days of hire.
• Minimum 3 years of experience in securing medical claim payments, managing follow-up, and appealing denials, with proven success resolving complex, high-value claims.
• Advanced knowledge of ICD-10, CPT/HCPCS, payer policies, and reimbursement regulations.
• Strong negotiation, research, and problem-solving abilities.
• Experience using EHR/EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms to support billing and account resolution.
• Proficiency in Microsoft Office Suite, Teams, and various desktop applications.

Knowledge, Skills, And Abilities

• Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes.
• Knowledge of rules and regulations relative to Healthcare Revenue Cycle administration.
• Skills in investigating medical accounts and resolving claims.
• Ability to validate payments.
• Ability to make decisions and act.
• Ability to learn and use collaboration tools and messaging systems.
• Ability to maintain a positive outlook, a pleasant demeanor, and act in the best interest of the organization and the client.
• Ability to research healthcare revenue cycle rules and regulations
• Ability to take professional responsibility for quality and timeliness of work product.

Disclosure Statement

As part of the Currance application and hiring experience, all candidates are subject to a criminal background check, employment verification check and a government exclusion check. The government exclusion check is a mandatory screening process that verifies whether an individual is listed on federal or state exclusion or watchlists, including but not limited to, the Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) and the System for Award Management (SAM.gov).

These screenings are conducted to ensure compliance with applicable federal and state laws and regulations, to protect the integrity of federally funded programs, the clients we support, and to prevent participation by individuals who are excluded due to fraud, abuse, or other misconduct. By submitting an application, candidates acknowledge and consent to these checks as a condition of employment or engagement.