Account Resolution Specialist – Insurance HMOs

Vaga não está no LinkedIn

🕒 Julho 28

Candidatar-se

Encontrar Vagas Remotas Similares

Configurar Alerta de Email para Novas Vagas

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo

Sarnova

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2008

🏥 Saúde

🤝 B2B

☁️ SaaS

💰 $500.000 Venture Round - Sarnova em 2009-12

Healthcare • B2B • SaaS

A Sarnova é uma empresa de distribuição e serviços focada em saúde, cujo grupo de negócios (incluindo Bound Tree Medical, Tri-anim Health Services, Cardio Partners e Digitech) fornece produtos, equipamentos, serviços e tecnologia para todo o continuum de serviços médicos de emergência (EMS) e cuidados agudos. Há quase 50 anos, o grupo distribui mais de 100 mil produtos de saúde e segurança para prestadores de EMS, hospitais, escolas, empresas e agências governamentais, além de fornecer soluções para cuidados respiratórios/anestesia/atenção crítica, vendas e gestão de programas de DEA, treinamento de RCP e uma plataforma de faturamento e inteligência de negócios em nuvem para EMS. A Sarnova é uma empresa do portfólio de Patricia Industries/Investor AB.

Descrição

• Research and resolve outstanding insurance claims, including those that are pending, unable to be released, denied, or paid incorrectly by commercial insurance carriers • Investigate claims placed on hold, identifying root causes, correcting errors, and executing needed follow‑up actions to release claims for processing • Analyze insurance denials, determining denial reasons, assessing validity, and completing the appropriate resolution steps such as appeals, corrections, or resubmission • Communicate directly with insurance carriers via outbound calls to obtain claim status, clarify discrepancies, and secure detailed explanations for pending or denied claims • Prepare and submit additional documentation requested by insurance carriers to support claim adjudication and ensure accurate processing • Draft and submit appeals when necessary, ensuring they are supported by proper documentation, regulatory guidelines, and payer‑specific requirements • Process and manage incoming correspondence, including mail, emails, EOBs, requests for information, and any necessary refunds • Maintain accurate, detailed notes in billing systems for all follow‑up activities, findings, and next steps • Identify trends or recurring issues, escalating concerns to supervisors or appropriate internal teams to support process improvement • Meet daily productivity and accuracy expectations, contributing to a high‑performing team environment • Additional job duties as assigned

🎯 Requisitos

• Education: High School Diploma or equivalent required • Strong computer skills, including working knowledge of MS Outlook, Word, and Excel • Ability to type 40 WPM with accuracy • Proven ability to handle high‑volume workloads, prioritize effectively, and meet tight deadlines • Experience in a structured environment where call monitoring, performance metrics, or productivity scoring are used is helpful • Strong verbal communication skills with the ability to remain calm, professional, and effective during phone interactions with insurance carriers • Excellent written communication skills for crafting clear, accurate documentation and correspondence • Exceptional attention to detail and accuracy in reviewing claims, identifying discrepancies, and documenting findings • Highly organized, self‑paced, and capable of managing work independently in a remote environment • Dependable, punctual, and accountable, with a willingness to ask questions and seek clarification when needed • Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

🏖️ Benefícios

• Competitive salary, commensurate with experience • Comprehensive benefits package, including 401(k) Plan