Variance Resolution Specialist

Location:

Aurora

Position Type:
Regular

Regular/Temporary:
Regular

Estimated Close Date: 10/30/2026

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

• 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.

• 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

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

• 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.

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