Account Resolution Specialist III - HB

Currance; United States; Remote; Full time

Job summary

Currance is seeking skilled professionals for a remote role focused on managing healthcare revenue cycle operations. The position involves overseeing claim submissions, resolving issues with healthcare claims, and requires experience in hospital billing. Candidates will work with health insurance companies to ensure timely payments and manage complex account resolutions.

Benefits

Paid time off

401(k) plan

Health insurance (medical, dental, and vision)

Life insurance

Paid holidays

Training and development opportunities

Focus on wellness and support for work-life balance

Qualifications

• 3-5 years of experience working with health insurance companies.
• Experience with hospital and physician claim follow up and appeals.

Responsibilities

• Oversee proper claim submission and payment.
• Resolve escalated and stalled claims.
• Train new hires on workflow as needed.

Skills

Knowledge of ICD-10 Diagnosis and procedure codes

Knowledge of rules and regulations relative to Healthcare Revenue Cycle

Skilled in medical accounts investigation

Ability to validate payments

Education

Bachelor’s degree in Revenue Cycle Management or related field

Tools

MedHOST

Artiva

Microsoft Office Suite

Teams

GoToMeeting

Zoom

Job description

We are hiring in the following states:
AZ, CA, CO, CT, FL, GA, HI, IL, MA, ME, MN, MO, NC, NJ, NV, OK, PA, SD, TN, TX, VA, WA

This is a remote position. Candidates who meet the minimum qualifications will be required to complete a video prescreen to move forward in the hiring process.

Hourly Rate: Up to $23.00/hour based on experience

At Currance, we believe in recognizing the unique skills and experiences that each candidate brings to our team. Our overall compensation package is competitive and is determined by a combination of your experience in the industry and your knowledge of revenue cycle operations. We are committed to offering a rewarding environment that aligns with both individual contributions and our company goals.

Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, a focus on wellness and support for work-life balance, and more.

Please note that we are looking for people who have hospital billing experience incollections and have some HB billing experience,in high dollar collections, adjustments and denials management.

Job Overview

Ensure continuation of revenue flow by overseeing proper claim submission and payment through review and correction of claim edits, errors, and denials. Act as SME for account resolution for physician claims (CMS-1500), as well as payment for hospital claims through review and correction of claim edits, errors, and denials. Utilize review and payer guidelines. Work with all client teams.


Job Duties and Responsibilities

• Perform tasks to generate revenue through account resolution for any Company client.
• Work with clients across Flex Workforce organization.
• Resolve escalated and/or stalled claims.
• May be responsible for training new hires on both client and Currance workflow (as needed).
• Mentor ARS Is and ARS IIs to increase skill levels.
• Submit claims in accordance with Federal, State, and payer mandated guidelines.
• Comply with productivity standards while maintaining quality levels.
• Responsible to research, analyze, and review claim errors and rejections and make applicable corrections.
• Ensure that claims submitted to payers are not returned nor denied due to controllable error.
• Maintain required knowledge of payer updates and process modifications to ensure accurate claims.
• Investigate, follow up with payers, and collect on insurance accounts receivables.
• Verify that accounts display accurate liability and balance with payer.
• Identify any payer specific issues and communicate to team and manager.
• Participate and contribute to daily shift briefings.

Qualifications

• Bachelor’s degree in Revenue Cycle Management or related field preferred.
• MedHOST experience is required; Artiva preferred.
• 3-5 years of experience working with health insurance companies in securing payment for medical claims.
• 3-5 years of experience with hospital and physician claim follow up and appeals with health insurance companies.
• Experience with multiple systems, e.g., MedHOST preferred.
• Expertise with computer including Microsoft Office Suite/Teams and GoToMeeting/Zoom, etc.

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
• Skilled in medical accounts investigation.
• Skilled in achieving results with little to no oversight.
• Skilled to investigate and resolve escalated claims
• Skilled in research to identify new rules and regulations relative to Healthcare Revenue Cycle administration
• Ability to validate payments
• Ability to make decisions and take action.
• Ability to maintain a positive outlook, pleasant demeanor, mature nature during all interactions, and act in the best interest of the organization and the client.
• Ability to take professional responsibility for quality and timeliness of work product.