State Licensed Account Resolution Specialist

Managing complex, high-dollar insurance accounts, the fully remote State Licensed Account Resolution Specialist will resolve denials, submit claims, and ensure compliance with payer regulations while meeting productivity and quality goals. Key responsibilities Independently manage high-volume accounts with significant financial impact Submit accurate medical claims and resolve multi-level denials through advanced research and follow-up Prepare and submit appeals with supporting documentation, ensuring thorough tracking 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 denials Advanced knowledge of ICD-10, CPT/HCPCS, and payer policies Experience using EHR/EMR systems such as Epic, Cerner, or Meditech