Job Description - Account Resolution Specialist III - HB
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 in collections 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.
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