Account Resolution Specialist II

Job Summary

Managing insurance claims remotely, the full-time Account Resolution Specialist II will oversee claim denials, appeals, and account follow-up to ensure timely payment processing for clients in the healthcare sector.

Key responsibilities:

• Submit and manage medical claims, ensuring compliance with federal, state, and payer-specific requirements
• Investigate claim errors and rejections, following up with payers to resolve issues and collect accounts receivable
• Prepare and submit appeals with supporting documentation while maintaining productivity and quality standards

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 Meditech, Epic, or similar platforms
• Strong knowledge of ICD-10, CPT/HCPCS, payer guidelines, and the revenue cycle process
• Proficiency in Microsoft Office Suite and various desktop applications