Account Resolution Specialist III

Currance

. Independently manage high-dollar, high-volume, and complex hospital billing accounts .

Posted 11/6/2026full-timeRemote • United StatesMid-LevelSenior💰 $21 - $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing complex hospital billing accounts, ensuring compliance with federal and state regulations, and effectively resolving claim denials. Proficient in utilizing EHR systems and analyzing payment discrepancies to maximize reimbursement.

Highest-signal resume keywords

CRCR CertificationICD-10 KnowledgeEHR/EMR Systems ExperienceMedical Claims ManagementStrong Negotiation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Claims SubmissionDenial ResolutionPayment Discrepancy AnalysisReimbursement MaximizationClaims VerificationAppeals PreparationHealthcare Revenue Cycle KnowledgeICD-10 CodingCPT/HCPCS CodingAccount Adjustments

Soft Skills

Problem-Solving AbilitiesResearch SkillsCollaboration SkillsNegotiation Skills

Tools & Technologies

EpicCernerMeditechAllscriptsMicrosoft Office SuiteTeamsArtivaPayer Portals

Certifications & Qualifications

CRCR Certification

Industry Keywords

Healthcare Revenue CyclePayer PoliciesFederal RegulationsState RegulationsInsurance Accounts Receivables

About the role

Key responsibilities & impact

Independently manage high-dollar, high-volume, and complex hospital billing accounts
Submit accurate medical claims in compliance with federal, state, and payer-specific requirements
Resolve multi-level denials through advanced research, payer escalation, and detailed follow-up
Investigate and follow up with payers to collect insurance accounts receivables
Prepare and submit first- and second-level appeals with complete supporting documentation
Execute and oversee EHR workflows in Epic, Cerner, Meditech, and Allscripts, including reroutes, denial closures, and account adjustments
Review EOBs to resolve payment discrepancies, claim denials, and contractual underpayments
Complete rebills and corrections to maximize reimbursement
Analyze payment discrepancies and take corrective actions
Meet productivity and quality benchmarks: 125% of project daily goal and 95% monthly quality assurance score
Research, analyze, and correct errors and rejections; identify root causes and implement preventive solutions
Verify and adjust claims to ensure accurate client liability and account balance
Stay informed about payer guideline and process changes
Identify payer trends affecting reimbursement and report findings to management
Participate in daily shift briefings and contribute as needed
Support an Acute Hospital client environment using Epic, Artiva, and payer portals including Availity

Requirements

What you’ll need

High school diploma or equivalent required
Associate's degree preferred
CRCR certification or completion of certification required within 90 days of hire
Minimum 3 years of experience in securing medical claim payments, managing follow-up, and appealing denials, with proven success resolving complex, high-value claims
Advanced knowledge of ICD-10, CPT/HCPCS, payer policies, and reimbursement regulations
Strong negotiation, research, and problem-solving abilities
Experience using EHR/EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms to support billing and account resolution
Proficiency in Microsoft Office Suite, Teams, and various desktop applications
Knowledge of ICD-10 diagnosis and procedure codes and CPT/HCPCS codes
Knowledge of rules and regulations relative to Healthcare Revenue Cycle administration
Ability to validate payments, make decisions, use collaboration tools, research healthcare revenue cycle rules and regulations, and take professional responsibility for quality and timeliness
Subject to criminal background, employment verification, and government exclusion checks as a condition of employment or engagement