State Licensed Account Resolution Specialist

A company is looking for an Account Resolution Specialist III, responsible for managing complex insurance accounts and ensuring timely claim resolution.

Key Responsibilities

Independently manage high-dollar, high volume, and complex accounts with significant financial impact

Submit accurate medical claims and resolve multi-level denials requiring 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 appealing denials

Advanced knowledge of ICD-10, CPT / HCPCS, payer policies, and reimbursement regulations

Experience using EHR / EMR systems such as Meditech, Epic, Cerner, or similar platforms