Insurance Account Resolution Specialist

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🕒 Julho 28

⚔️ Virginia – Remoto

⚔️ Virginia – Remote

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🔒 Seguros

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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 resubmissions • 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

• Comprehensive benefits package • 401(k) Plan