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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare revenue cycle administration, including claim resolution processes, compliance with CMS rules, and effective team leadership. Proficient in managing productivity metrics and coaching staff to enhance performance and accuracy in claim resolutions.
Highest-signal resume keywords
CRCR CertificationHealthcare Revenue Cycle AdministrationArtiva Account Resolution WorkflowsEMR Systems (Meditech, Epic, Cerner, Allscripts, Nextgen)Team Leadership and Development
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claim Resolution ProcessesDenial and Appeal WorkflowsPayer RulesCARC/RARC CodesProductivity Metrics MonitoringQuality Metrics AnalysisMedical Claim PaymentsEscalation StrategiesProject ManagementCoaching and Mentoring
Soft Skills
Strong Written CommunicationStrong Verbal CommunicationTeam CollaborationProblem-SolvingTime Management
Tools & Technologies
Microsoft Office SuiteMicrosoft TeamsDesktop ApplicationsEMR Systems
Certifications & Qualifications
CRCR Certification
Industry Keywords
HealthcareRevenue CycleClaim Follow-UpComplianceHIPAAPayer StandardsQuality AuditsEmployee Success Plans
About the role
Key responsibilities & impact- Provide direct leadership to Account Resolution Specialists levels I–IV and the Operations Team Lead
- Oversee daily claim resolution activities, including edits, denials, and appeals
- Manage team productivity, accuracy, quality, and compliance with payer and organizational standards
- Conduct one-on-one sessions, coaching, mentoring, onboarding, and training
- Lead interviews and hiring for Account Resolution Specialists and Team Leads
- Monitor productivity standards and quality metrics
- Review weekly quality audits and deliver targeted coaching
- Escalate employee deficiencies and administer disciplinary actions or Employee Success Plans as needed
- Communicate team and individual progress with the Operations Manager
- Review and approve team payroll
- Complete performance evaluations for direct reports
- Analyze claim errors and rejections to identify trends and process improvements
- Monitor payer updates and communicate changes to the team
- Ensure accurate adjustments and compliance with client policies
- Investigate problem accounts and escalate unresolved client IPO issues
- Lead daily shift briefings
- Collaborate with management to develop policies
- Attend client payer or internal meetings
- Complete assigned projects and additional duties as needed
- Promote compliance through routine huddles, meetings, communications, and decision-making
Requirements
What you’ll need- High school diploma or equivalent required
- CRCR certification required or must be obtained within 90 days of hire
- At least 2 years in a supervisory or leadership role
- At least 3 years of experience securing medical claim payments from health insurance companies, including claim follow-up and appeals
- Experience with complex insurance claims, high-value denials, and escalation strategies
- A minimum of 3 years’ experience with Artiva for account resolution workflows is preferred
- Experience with EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms
- Proficiency in Microsoft Office Suite, Teams, and desktop applications
- Comprehensive understanding of healthcare revenue cycle administration, CMS rules, HIPAA, payer rules, CARC/RARC codes, denial and appeal workflows, and claim resolution processes
- Ability to monitor and interpret productivity and quality metrics
- Ability to coach, mentor, and develop staff across multiple levels
- Ability to manage competing priorities while maintaining accuracy and timeliness
- Strong written and verbal communication skills
- Ability to initiate and complete projects independently
- Willingness and ability to learn new software applications and processes
- Background check and government exclusion check required as conditions of employment
Benefits
Comp & perks- Limited travel as required
- Professional development and staff training opportunities
- Coaching, mentorship, and onboarding support
- Compliance-focused work environment
- Criminal background check and government exclusion check as employment conditions
