Account Resolution Specialist – Insurance HMOs

Job not on LinkedIn

🔥 8 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔒 Insurance

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Sarnova

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2008

🏥 Healthcare

🤝 B2B

☁️ SaaS

💰 $500k Venture Round - Sarnova on 2009-12

Healthcare • B2B • SaaS

Sarnova is a healthcare-focused distribution and services company whose family of businesses (including Bound Tree Medical, Tri-anim Health Services, Cardio Partners, and Digitech) supplies products, equipment, services and technology across the emergency medical services (EMS) and acute care continuum. For nearly 50 years the group has distributed more than 100,000 health and safety products to EMS providers, hospitals, schools, businesses and government agencies, and also provides respiratory/anesthesia/critical care solutions, AED sales and program management, CPR training, and a cloud-based EMS billing and business intelligence platform. Sarnova is a portfolio company of Patricia Industries/Investor AB.

📋 Description

• Research and resolve outstanding insurance claims, including pending, unreleased, denied, or incorrectly paid claims from Medicare HMOs, Medicaid MCOs, and Facilities • Investigate claims placed on hold, identify root causes, correct errors, and execute follow-up actions to release claims for processing • Analyze insurance denials and complete appeals, corrections, or resubmissions • Communicate with insurance carriers via outbound calls to obtain claim status and clarify discrepancies • Prepare and submit documentation requested by insurance carriers • Draft and submit appeals with proper documentation and payer-specific requirements • Process incoming correspondence, including mail, emails, EOBs, information requests, and refunds • Maintain accurate notes in billing systems for follow-up activities, findings, and next steps • Identify recurring issues and escalate concerns to supervisors or internal teams • Meet daily productivity and accuracy expectations • Perform additional duties as assigned

🎯 Requirements

• 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

🏖️ Benefits

• Competitive salary, commensurate with experience • Comprehensive benefits package • 401(k) Plan • Remote, work-from-home position