Account Resolution Specialist, Collections (Remote)
Louisville, Kentucky Facility Kindred Hospitals Louisville Central Business Office
Req ID 542543 Post Date 07 / 01 / 2025 Category Accounting and Finance
Description
At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.
Job Summary
- The Account Resolution Specialist will be responsible for supporting A / R resolution in our Central Business Office by effectively and efficiently researching claims and taking action with the insurance payers to achieve timely account adjudication
- The ideal candidate has the ability to recognize and solve issues as appropriate, interpret contract terms to ensure accounts receivables are properly stated, in addition to writing and processing underpayment technical appeals
Essential Function
Review unpaid claims, research reasons for delay, and work with payers to resolve the issuesInitiate collection follow-up of unpaid or denied claimsEffectively follows up on appeals and resolves claim rejections, underpayments, and denialsResearch technical payer denials related to referral, pre-authorization, non-covered services, and billing resulting in denials and delays in payment; Initiate appeals with insurers appropriatelyDevelop and submit detailed, customized appeals to payers based on review of denial, applicable records, and in accordance with payer guidelines as well as Kindred’s policies and proceduresReview outstanding accounts and aging reportsProcesses adjustments when requiredResponsible for stat using of A / RReplies to insurance companies requests for additional documentation in a timely mannerCommunicates pertinent information to Business Office DirectorTrack trending issuesWork with multiple systems dailyReview EOB’s to identify payment errors, denials and low reimbursementMake phone calls regularly to insurance companies for claim follow upResearch account receivables for both Medicare and Non-Medicare collectionsConduct thorough account research and analysisRecognize, reconcile and resolve account discrepanciesProvide timely notation of action taken on patient accounts; process refunds to insurance carrier or patient; correct late charges; monitor insurance coding and effective / exhaust datesResponsible for identifying net revenue hits and pick-upsResponsible for underpayment variance reviewsResponsible for identifying, logging, and effectively working denialsAbility to read an insurance contract and monitor claims accordinglyKnowledge / Skills / Abilities
Demonstrate ability to research, analyze and resolve problemsAbility to multi-taskGood communication skills (both verbal and written)Ability to use independent judgment to recognize and solve issuesDemonstrates the ability to work independently and takes initiativeDesire to make a positive impact with the ability to manage multiple tasks and shift prioritiesTeam player with a strong sense of ownership and accountabilityDetail oriented, organized, and motivatedQualifications
Education
High School DiplomaExperience
2+ years of experience in healthcare collections