Variance Resolution Specialist

Children's Hospital Colorado; Aurora (CO); Hybrid; USD 32,000 - 47,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

403b match

Parental leave

Wellness program

Education benefit

Job summary

Children's Hospital Colorado in Aurora, CO is seeking a Variance Resolution Specialist to reconcile patient accounts with enhanced EOB processing and payor communications. The role requires advanced account review, contract application, and collaboration with Revenue Cycle and other departments to resolve discrepancies.

The position is full time (40 hours/week) with a day shift and hybrid work arrangement. Benefits include comprehensive health coverage, retirement options, and professional

Qualifications

• High School diploma or GED.
• Five (5) years of healthcare and/or accounts receivable experience.

Responsibilities

• Interprets EOB/insurance processing to understand and resolve accounts.
• Identifies and prioritizes accounts and work queues, based on scoring, type, payor, dollar, etc.
• Investigates accounts based on contract segments, types of accounts, thresholds, and other requirements.
• Ensures accuracy in credits and/or debits processing while adhering to regulations and policies.
• Interprets contracts and contract summaries to advise correct applications for an account.

Skills

EOB interpretation

Accounts receivable

Contract interpretation

Audit experience

Collaboration

Education

High School diploma or GED

Job description

Job ID: 108329

Location: Aurora

Position Type: Regular

Regular/Temporary: Regular

Estimated Close Date: 10/30/2026

Job Overview

The Variance Resolution Specialist is an advanced-level variance (credit and/or debit) position Ensures reconciliation of patient accounts with enhanced EOB/insurance processing understanding, responds accurately and timely to payers' correspondence, provides advanced credit account review with understanding of contract summaries and application to account types, and collaborates with Revenue Cycle and appropriate departments on accounts during discrepancies. Recognizes deviations from contractual expectation and payor activities or decisions, recognize gaps in payment/reasoning or system errors, handles escalated and complex accounts, audits accounts for accuracy, and works accounts to completion/resolution. Identifies trends or gaps where appropriate and follows through to ensure solutions.

Additional Information

• Department Name: Patient Financial Services
• Job Status: Full time, 40 hours per week.
• Shift: Day, OPEN 6a-6p, 8 hrs IN THAT TIMEFRAME, Hybrid

Duties & Responsibilities

• Interprets EOB/insurance processing to understand and resolve accounts.
• Identifies and prioritizes accounts and work queues, based on scoring, type, payor, dollar, etc.
• Investigates accounts based on contract segments, types of accounts (i.e. outpatient, inpatient, series, etc.), thresholds, Single Case Agreements, and other requirements/components.
• Ensures accuracy in credits and/or debits processing while adhering to all regulations, objectives, operating policies and procedures, and strategic action plans for achieving goals.
• Interprets contracts and contract summaries to advise correct applications for an account.
• Recognizes and solves for deviations from contractual expectation and payor activities/decisions, recognize gaps in payment/reasoning or system errors. Compiles and maintains various documentation and other reporting requirements.
• Works on projects such as Novita's, Medicaid and Medicare Audits, HMS. Supports and completes audit processes.
• Investigates and resolves assigned credit and/or debit balance accounts. Issues insurance refunds when appropriate.
• Calculates, corresponds on, and corrects contractual adjustments based on insurance contracts.
• Identifies root causes and provides solutions. Recognizes trends with payors and escalates as appropriate.
• Proficiently discusses accounts, records, and service with patients/insurance, as needed.
• Collaborates with patients, vendors, and internal departments to resolve conflicts on accounts and resolves any outstanding credit and/or debit balances of unapplied/unidentified payment receipts. Prints and mails any required hard copy forms to insurance companies, including recoupment letters, etc.

Minimum Qualifications

• Degrees
  • High School diploma or GED
• Area of Study
  • Not Applicable.
• Experience
  • Minimum Experience. Required:Five (5) years of healthcare and/or accounts receivable experience.
• Equivalency
  • Not Applicable
• Licenses & Certifications
  • None
• Additional Requirements
  • Not Applicable.
• Competency
  • None

Salary Information

• Pay is dependent on applicant's relevant experience.
• Hourly Range: $22.87 to $34.30

Benefits Information

• Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.

EEO Statement

• It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date.
• Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.