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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 productivity goal
- Achieve a 90% monthly quality assurance score
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 healthcare revenue cycle administration regulations and rules
- Ability to investigate medical accounts and validate payments
- Ability to make decisions, take action, learn collaboration and messaging tools, work independently, and achieve results with minimal oversight
- Subject to criminal background, employment verification, and mandatory government exclusion checks as a condition of employment or engagement
- Availability to work CST hours; preferred shifts are 7:00 AM–3:30 PM CST or 8:00 AM–4:30 PM CST