Account Resolution Specialist III

🕒 Julho 3

🌵 Arizona, California, +19 estados a mais – Remoto

🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote ⚜️ Louisiana – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🏖️ New Jersey – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $21 - $23 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

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Currance

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 2020

🏥 Saúde

🤝 B2B

🏢 Corporativo

Healthcare • B2B • Enterprise

Currance é uma empresa de gestão do ciclo de receita focada em saúde que faz parceria com hospitais, sistemas de saúde e grupos de médicos para otimizar os fluxos de trabalho de faturamento, cobranças e administrativos. Eles fornecem soluções personalizáveis, habilitadas por tecnologia e híbridas - resolução de seguros, gestão de seguros e serviços terceirizados de escritório de negócios - para acelerar a coleta de caixa, reduzir os dias de contas a receber e melhorar os resultados. A Currance opera como um fornecedor de serviços B2B, oferecendo melhorias consultivas do ciclo de receita orientadas por desempenho em grandes organizações de saúde e comunidades.

Descrição

• Independently manage high-dollar, high volume, and complex accounts with significant financial impact • Submit accurate medical claims in compliance with federal, state, and payer-specific requirements • Resolve multi-level denials that require advanced research, payer escalation, and detailed follow-up • Investigate and follow up with payers to collect insurance accounts receivables • Prepare and submit first- and second-level appeals with complete supporting documentation, ensuring thorough tracking and follow-up to maximize reimbursement • Execute and oversee EHR workflows in systems such as Epic, Cerner, Meditech, and Allscripts, including reroutes, denial closures, and account adjustments • Review Explanation of Benefits (EOBs) to resolve payment discrepancies, claim denials, and contractual underpayments • Complete rebills and corrections to maximize reimbursement • Transforming revenue cycle differently. Improving healthcare together • Analyze discrepancies in payments and take corrective actions as needed • Meet productivity benchmarks while maintaining high-quality standards • Research, analyze, and correct errors and rejections, identify root causes, and implement preventive solutions • Verify and adjust claims to ensure accurate client liability and account balance • Stay informed about changes in payer guidelines and processes for accurate claim submissions • Identify payer trends impacting reimbursement and bring findings to management for review • Participate in daily shift briefings and contribute as needed

🎯 Requisitos

• High school diploma or equivalent required; Associate's degree preferred • CRCR certification or completion of certification required within 90 days of hire • Minimum 3 years of experience in securing medical claim payments, managing follow-up, and appealing denials, with proven success resolving complex, high-value claims • Advanced knowledge of ICD-10, CPT/HCPCS, payer policies, and reimbursement regulations • Strong negotiation, research, and problem-solving abilities • Experience using EHR/EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms to support billing and account resolution • Proficiency in Microsoft Office Suite, Teams, and various desktop applications

🏖️ Benefícios

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development