Healthcare Account Resolution Specialist

Job Summary

A company is looking for an Account Resolution Specialist IV to manage complex healthcare claims and ensure timely resolution and payment processing.

Key Responsibilities

• Independently manage high-dollar, aged, and complex accounts requiring advanced research and payer knowledge
• Analyze and resolve high-value claims according to payer specific guidelines and regulations
• Mentor other specialists and lead continuous improvement efforts in claim resolution processes

Required Qualifications

• High school diploma or equivalent required; Associate's degree preferred
• Bachelor's degree in healthcare management or related field preferred
• CRCR certification or completion of certification required within 90 days of hire
• Minimum 5 years of experience securing medical claim payments from health insurance companies
• Minimum 3+ years of experience using Artiva for account resolution workflows preferred