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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical claims processing, including submission, follow-up, and appeals, while ensuring compliance with payer guidelines and regulations. Proficient in utilizing EMR/EHR systems and Microsoft Office Suite to manage accounts receivable and achieve quality assurance goals.
Highest-signal resume keywords
Medical Claims ProcessingICD-10 KnowledgeEMR/EHR Systems ExperiencePayer Guidelines ComplianceAccounts Receivable Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical Claims SubmissionClaim Follow-UpAppealing Denied ClaimsICD-10CPT/HCPCSRevenue Cycle ProcessBasic Coding PrinciplesPayer-Specific Billing RequirementsPayment ValidationQuality Assurance
Soft Skills
Strong Communication SkillsAdvocacy with PayersDecision-MakingIndependent WorkProblem-Solving
Tools & Technologies
Microsoft Office SuiteTeamsMeditechEpicCernerAllscriptsNextGen
Industry Keywords
Healthcare Revenue CycleClaim EditsInsurance Accounts ReceivablePayer UpdatesRegulations and Rules
About the role
Key responsibilities & impact- Submit medical claims according to federal, state, and payer-specific requirements
- Review and correct claim edits, errors, and denials to ensure accurate payment
- Investigate and analyze claim errors and rejections
- Follow up with payers and collect assigned insurance accounts receivable
- Monitor payer updates and process changes
- Evaluate non-payment reasons and resolve client claims
- Prepare and submit first- and second-level appeals with supporting documentation
- Identify and document coding, clinical, and registration issues for referral and correction
- Escalate stalled claims to payers or Currance leadership
- Verify and adjust claims so client accounts reflect correct liability and balances
- Identify payer-specific issues and communicate them to the team and manager
- Perform other duties assigned to support business needs
- Achieve 100% of the project daily goal
- Achieve a 90% monthly quality assurance score
- Manage accounts receivable from claim billing through final resolution across government and commercial payer portfolios
Requirements
What you’ll need- High school diploma or equivalent
- Minimum 2 years of experience securing medical claim payments from health insurance companies
- Experience managing claim follow-up and appealing denied claims with healthcare vendors or providers
- Experience using EMR/EHR systems such as Meditech, Epic, Cerner, Allscripts, NextGen, or similar platforms
- Strong working knowledge of ICD-10, CPT/HCPCS, payer guidelines, and the revenue cycle process
- Strong written and verbal communication skills, with ability to advocate effectively with payers
- Proficiency in Microsoft Office Suite, Teams, and various desktop applications
- Knowledge of basic coding principles and payer-specific billing requirements
- Knowledge of regulations and rules related to Healthcare Revenue Cycle administration
- Skilled in investigating medical accounts
- Ability to validate payments
- Ability to make decisions and take action
- Ability to quickly learn and use collaboration and messaging tools
- Ability to work independently and achieve results with minimal oversight
- Candidates are subject to criminal background, employment verification, and mandatory government exclusion checks as a condition of employment or engagement
Benefits
Comp & perks- Remote work
- Team coverage hours from 7:30 AM to 7:30 PM CST
- Criminal background check, employment verification check, and government exclusion check conducted as part of the hiring process