Senior AR Resolution & Denials Specialist II

3110 Kennestone Hospital, Inc.; Georgia; Hybrid; USD 52,000 - 68,000; Full time

Job summary

Wellstar Health System is seeking an Account Resolution Representative II in Georgia to support planning and coordination of follow-up activities for a large AR portfolio. You will analyze trends, develop improvement strategies, and ensure timely appeal or adjustment within payer timeframes while collaborating with leadership.

The role requires strong data analysis, proficiency with MS Office and Epic/Emdeon systems, and the ability to educate teammates.

Qualifications

• Minimum 1 year experience as an Account Follow-up Representative I or a minimum of two (2) years in hospital patient financial services.
• Strong knowledge of Governmental, i.e. Medicare, Medicaid and/or Non-Governmental, i.e. Commercial: healthcare revenue cycle functions, denials management, payor appeals and reimbursement methodology.
• Proficient with MS Word, PowerPoint, and MS Excel; able to perform analysis and reporting

Responsibilities

• Respond to inquiries from 3rd parties, insurance providers and patients regarding accounts.
• Collect and resolve payments from insurance companies by working with payers and following policies.
• Research and resolve payer rejected/denied claims and analyze accounts for policy compliance and payout accuracy.
• Review denial reports and propose denial prevention solutions.
• Maintain Epic workqueues to ensure timely resolution of review requests and support training.

Skills

Data analysis

Trend analysis

MS Office

Excel

PowerPoint

Word

Outlook

Epic

Emdeon Claims Master

Communication skills

Problem solving

Analytical skills

Education

High School Diploma / GED

Certified Revenue Cycle Representative (Preferred)

Tools

Epic

Emdeon Claims Master

Job description

Wellstar Health System is seeking an Account Resolution Representative II in Georgia to support planning and coordination of follow-up activities for a large AR portfolio. You will analyze trends, develop improvement strategies, and ensure timely appeal or adjustment within payer timeframes while collaborating with leadership.

The role requires strong data analysis, proficiency with MS Office and Epic/Emdeon systems, and the ability to educate teammates.