Account Resolution Specialist Team Lead

Description: We are hiring in the following states:

AR, AZ, CA, CO, FL, GA, IA, IL, LA, MA, ME, MO, NC, NE, NJ, NV, OK, PA, SD, TN, TX, VA, WA, and WI

This is a remote position.Pay is based on experience.

At 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 in collections and have some HB billing experience, in high dollar collections, adjustments and denials management.

Job Overview

Provide mentoring to Account Resolution Specialists (ARS) I and II. Ensure proper claim submission and payment for hospital claims through review and correction of claim edits, errors and denials. Utilize review and payer guidelines

Requirements

Job Duties and Responsibilities

• Acts as mentor to assigned ARS team for hospital claims.
• Provides ongoing feedback on ARS performance to improve productivity.
• Submits hospital claims in accordance with Federal, State, and payer mandated guidelines.
• Comply with productivity standards while maintaining quality levels.
• Responsible to research, analyze, and review hospital claim errors and rejections and make applicable corrections.
• Ensures that claims submitted to payers are not returned nor denied due to controllable error.
• Maintains required knowledge of payer updates and process modifications to ensure accurate claims.
• Investigate, follow up with payers, and collect on insurance accounts receivables.
• Escalate stalled hospital claims.
• Verify hospital accounts display accurate liability and balance with payer.
• Identify any payer specific issues and communicate to team and manager.
• Lead and contribute to daily shift briefings.
• Review employee scorecards daily and provide coaching to employee if not meeting key metrics.
• Escalate employee deficiency to manager if coaching attempts have failed.
• Research problem accounts.
• Escalate client IPO issues to manager if not resolved internally.
  
  

Qualifications

• High school diploma or equivalent
• Experience working with health insurance companies securing payment for medical claims
• Experience with billing hospital and professional claims (HCFA1500 and UB04)
• Experience filing appeals with health insurance companies
• Two plus years of experience in medical billing or follow up with hospital using claim form HCFA 1500.
• Proficiency with computer including Microsoft Office Suite/Teams and GoToMeeting/Zoom, etc.
• Experience with Epic
  
  

Knowledge, Skills, And Abilities

• Knowledge of rules and regulations relative to Healthcare Revenue Cycle administration
• Knowledge of ICD-10 Diagnosis and procedure codes and CPT/HCPCS codes
• Skilled to investigate medical accounts and identify reason/s for non-payment
• Skilled to take appropriate action to resolve accounts
• Skilled in computers and proficiency with Microsoft Office Suite/Teams and GoToMeeting/Zoom
• Ability to mentor others.
• Ability to make decisions and take action
• Ability to bring a positive outlook and pleasant demeanor to the job
• Ability and willingness to learn and grow
• Ability to receive and implement feedback towards continual performance improvement
• Ability to interact professionally in work and with colleagues
• Ability to be punctual, dependable, and adapt easily to change
• Ability to perform work duties using ethical decision making processes
• Ability to demonstrate accountability, responsibility, and revenue cycle accomplishments