Account Resolution Specialist II - Hospital (MedHOST Experience)

We are hiring in the following states:AZ, CA, CO, CT, FL, GA, HI, IL, MA, ME, MN, MO, NC, NJ, NV, OK, PA, SD, TN, TX, VA, WA 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: Up to $21.00/hour based on experienceAt Currance, we believe in recognizing the unique skills and experiences that each candidate brings to our team. Our overall compensation package is competitive and is determined by a combination of your experience in the industry and your knowledge of revenue cycle operations. We are committed to offering a rewarding environment that aligns with both individual contributions and our company goals.Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, a focus on wellness and support for work-life balance, and more.Please note that we are looking for people who have hospital billing experience incollections and have some HB billing experience,in high dollar collections, adjustments and denials management.

Job Overview

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

• 2 years of Medhost experience required; Artiva experience preferred.
• 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 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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