Currance, Inc. is Hiring an Account Resolution Specialist III - Physician Near Irvine, CA
We are hiring in the following States: AZ, CA, CO, CT, FL, GA, HI, MA, ME, MN, MO, NV, OK, PA, SD, TN, TX, WA Candidates must have Allscripts experience.This is a remote position. Candidates who meet the minimum qualifications will be required to complete a video prescreen to move forward in the hiring process. Hourly Rate: $21.00 - $23.00Benefits: PTO, 401K, medical, dental, vision, life insurance, paid holidays, and more Job OverviewEnsure continuation of revenue flow by overseeing proper claim submission and payment through review and correction of claim edits, errors, and denials. Act as SME for account resolution for physician claims (CMS-1500), as well as payment for hospital claims through review and correction of claim edits, errors, and denials. Utilize review and payer guidelines. Work with all client teams. Job Duties And Responsibilities
Perform tasks to generate revenue through account resolution for any Company client
Work with clients across Flex Workforce organization
Resolve escalated and/or stalled claims
Provide training and support to ARS Is and ARS IIs to improve quality and productivity
Mentor ARS Is and ARS IIs to increase skill levels
Submit claims in accordance with Federal, State, and payer mandated guidelines
Comply with productivity standards while maintaining quality levels
Responsible to research, analyze, and review claim errors and rejections and make applicable corrections
Ensure that claims submitted to payers are not returned nor denied due to controllable error
Maintain required knowledge of payer updates and process modifications to ensure accurate claims
Investigate, follow up with payers, and collect on insurance accounts receivables
Verify that accounts display accurate liability and balance with payer
Identify any payer specific issues and communicate to team and manager
Perform operations workflow training for new hires
Perform quality audits during training for new hires
Participate and contribute to daily shift briefings
Qualifications
Bachelor’s degree in Revenue Cycle Management or related field preferred
Allscripts experience is required
3-5 years of experience working with health insurance companies in securing payment for medical claims
3-5 years of experience with hospital and physician billing, claim follow up, and appeals with health insurance companies
Experience with multiple systems, e.g., Epic preferred
Expertise with computer including Microsoft Office Suite/Teams and 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
Skilled in achieving results with little to no oversight
Skilled to investigate and resolve escalated claims
Skilled in research to identify new rules and regulations relative to Healthcare Revenue Cycle administration
Ability to validate payments
Ability to make decisions and take action
Ability to maintain a positive outlook, pleasant demeanor, mature nature during all interactions, and act in the best interest of the organization and the client
Ability to take professional responsibility for quality and timeliness of work product.