Account Resolution Specialist

Job Summary

Managing insurance claims for clients, the fully remote Account Resolution Specialist III will ensure timely and accurate payment processing, handle claim denials and appeals, and perform follow-ups with commercial payers.

Key responsibilities:

• Submit and manage medical claims, ensuring compliance with federal, state, and payer-specific requirements
• Investigate claim errors, handle denials, and prepare appeals with necessary documentation
• Maintain accurate documentation and achieve productivity and quality assurance goals

Required qualifications:

• High school diploma or equivalent
• Minimum 2 years of experience in securing medical claim payments and managing claim follow-up
• Experience with EMR/EHR systems such as Epic or similar platforms
• Strong knowledge of ICD-10, CPT/HCPCS, and payer guidelines
• Proficiency in Microsoft Office Suite and collaboration tools