Account Resolution Specialist II - Hospital (client is in HST time zone) - Currance

We are hiring for a Maui-based client.

Hourly rate: $18.50 - $21.00
Hawaiian Standard Time (HST) resident hourly rate: $23.00 - $24.00

This is a remote position. You must be available and willing to work an 8-hour shift during the Maui client's hours, which are 5:00AM to 5:00PM (HST). Maui does not change time during the year. Based on Maui's time zone, the coordinating time zones are displayed below. Based on Daylight Savings and Standard times, your hours may shift as the times shift.

Daylight Savings Time
8:00 AM to 8:00 PM Pacific
9:00 AM to 9:00 PM Mountain
10:00 AM to 10:00 PM Central
11:00 AM to 11:00 PM Eastern

Standard Time
7:00 AM to 7:00 PM Pacific
8:00 AM to 8:00 PM Mountain
9:00 AM to 9:00 PM Central
10:00 AM to 10:00 PM Eastern

Some areas of the United States do not change time during the year. Please check the World Clock Buddy for information about your location.

Candidates who meet the minimum qualifications will be required to complete a video prescreen to move forward in the hiring process. 

Benefits: PTO, 401K, medical, dental, vision, life insurance, paid holidays, and more

Please note that we are looking for people who have hospital, follow-up, billing, and appeals experience. You must also have either EPIC or Allscripts experience.
 

Job Overview

This role includes managing insurance claims for our hospital clients, ensuring timely resolution and payment

processing. It also includes handling denials, appeals, and account follow-up across various payer types,

contributing to the financial success of the healthcare organizations that we support.

Job Duties and Responsibilities

• Submit medical claims in accordance with federal, state, and payer mandated guidelines.
• Ensure proper claim submission and payment through review and correction of claim edits, errors, and denials.
• Research, analyze, and review claim errors and rejections towards applicable corrections.
• Investigate, follow up with payers, and collect the insurance accounts receivable as assigned.
• Maintain required knowledge of payer updates and process modifications to ensure accurate claims submission, processing, and follow up.
• Assess the reasons for payer non-payment and take the required actions to successfully resolve claims on behalf of our clients.
• Escalate stalled claims to payer or Currance leadership.
• Verify and adjust claims to ensure that client accounts accurately reflect the correct liability and balance.
• Identify any payer specific issues and communicate to team and manager.
• Other duties and responsibilities as assigned to meet Company business needs.

Qualifications

• High school diploma or equivalent.
• One year experience working at Currance as an ARS I, 1 years of inpatient/outpatient medical billing/follow-up experience within a hospital or vendor setting to secure insurance payments or AR resolution.
• One year of experience with hospital and/or physician claim follow-up and appeals with health insurance companies.
• Experience in one or more EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or comparable platforms is required.
• Proficiency with computers including Microsoft Office Suite/Teams, 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.
• Ability to validate payments.
• Ability to make decisions and act.
• Ability to learn and use collaboration tools and messaging systems.
• Ability to maintain a positive outlook, a pleasant demeanor, and act in the best interest of the organization and the client.
• Ability to take professional responsibility for quality and timeliness of work product.
• Ability to achieve results with little oversight.

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