Account Resolution Specialist II

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
.

Join a collaborative hospital revenue cycle team responsible for follow-up on outstanding accounts receivable from claim submission through final resolution. We are seeking AR Specialists with strong account follow-up skills to work hospital-based portfolios. Responsibilities include researching and resolving complex insurance denials, billing errors, rebills, and appeals to ensure timely reimbursement while reducing aging AR and improving cash flow.

Accounts will include Medicare, Medicaid, Medicare Advantage, and commercial payers
, requiring strong knowledge of payer reimbursement guidelines, claim adjudication processes, and denial management strategies. Experience handling high-volume hospital accounts and familiarity with UB-04 billing standards is preferred. Prior experience with Medhost EHR is a plus but not required.

The ideal candidate demonstrates strong analytical skills, accounts receivable expertise, and adaptability in navigating payer-specific requirements while maintaining productivity and accuracy.
Experience with hospital billing workflows, appeal processes, and compliance with CMS regulations is highly valued.

Candidates should be available to work CST hours
; preferred shifts are 7:00 AM-3:30 PM CST or 8:00 AM-4:30 PM CST
.

As a healthcare revenue cycle business, we manage insurance claims and oversee timely claim resolution and payment processing for our clients. As an Account Resolution Specialist II, your main responsibility is to manage insurance claims for clients, ensuring that payments are processed accurately and in a timely manner. This role involves handling claim denials, appeals, and account follow-up for a variety of payer sources, all of which help maintain the financial stability of the healthcare organizations served.

• Submit medical claims in accordance with all federal, state, and payer-specific requirements.
• Ensure claims are correctly submitted and paid by reviewing and correcting edits, errors, and denials.
• Investigate and analyze claim errors and rejections to apply necessary corrections.
• Follow up with payers and collect assigned insurance accounts receivable.
• Stay informed about payer updates and process changes for accurate claims submission and follow-up.
• Evaluate reasons for non-payment and take appropriate action to resolve claims for clients.
• Prepare and submit first- and second-level appeals with supporting documentation in accordance with payer guidelines and timelines.
• Identify and document coding, clinical, and registration issues for referral to the appropriate teams to correct claim errors and prevent future denials.
• Escalate stalled claims to the payer or Currance leadership as needed.
• Verify and adjust claims so that client accounts reflect correct liability and balances.
• Transforming revenue cycle differently.
• Improving healthcare together.
• Identify issues specific to payers and communicate them to the team and manager.
• Perform other duties assigned to support business needs.
• Productivity:
  Achieve 100% of the project daily goal.
• Quality:
  Achieve 90% monthly quality assurance score.
• Other expectations:
  As outlined by the department.

• High school diploma or equivalent.
• Minimum 2 years of experience securing medical claim payments from health insurance companies, experience managing claim follow-up and appealing denied claims with healthcare vendors or providers.
• Experience using EMR/EHR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms to support billing and account resolution.
• Strong working knowledge of ICD-10, CPT/HCPCS, payer guidelines, and the revenue cycle process.
• Strong written and verbal communication skills, with ability to advocate effectively with payers.
• Proficiency in Microsoft Office Suite, Teams, and various desktop applications.

• Maintain current knowledge of basic coding principles, and payer-specific billing requirements to support claim resolution.
• Knowledge of regulations and rules related to Healthcare Revenue Cycle administration.
• Skilled in investigating medical accounts.
• Ability to validate payments.
• Capable of making decisions and taking action.
• Ability to quickly learn and…