State Licensed Account Resolution Specialist

Job Summary

A company is looking for an Account Resolution Specialist III, a senior-level position focused on resolving complex insurance accounts in a remote setting.

Key Responsibilities

• Independently manage high-dollar and complex accounts, ensuring timely resolution and payment processing
• Submit accurate medical claims and resolve multi-level denials through advanced research and follow-up
• Analyze payment discrepancies and implement corrective actions to maximize reimbursement

Required Qualifications

• 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 and managing follow-up
• Advanced knowledge of ICD-10, CPT/HCPCS, and payer policies
• Experience using EHR/EMR systems such as Meditech, Epic, or Cerner