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About the role
Key responsibilities & impact- Manage high-volume inpatient and outpatient accounts for a large pediatric hospital system and affiliated physician practices
- Resolve insurance denials and process first- and second-level appeals with supporting documentation
- Follow up on claims and collect assigned insurance accounts receivable
- Submit medical claims according to federal, state, and payer-specific requirements
- Review and correct claim edits, errors, and denials
- Investigate claim errors and rejections and apply necessary corrections
- Stay informed about payer updates and process changes
- Evaluate non-payment reasons and resolve claims for clients
- Identify and document coding, clinical, and registration issues for referral to appropriate teams
- 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
- Achieve 100% of the project daily goal and a 90% monthly quality assurance score
- Perform other duties assigned to support business needs
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
- Must meet criminal background, employment verification, and government exclusion screening requirements
Benefits
Comp & perks- Remote position
- Monday–Friday, 6:00 AM–2:30 PM MST schedule
- Criminal background check, employment verification check, and government exclusion check conducted as part of the hiring process