Senior Insurance Claims Follow-Up Specialist (Hospital and / or Physician Accounts) (IV)

Job Description

Job Description

Description :

We are hiring in the following states :

AR, AZ, CA, CO, CT, FL, GA, IA, IL, MN, MO, NC, NJ, NE, NV, OK, PA, SD, TN, TX, VA, WA, WI

This is a remote position . Candidates who meet the minimum qualifications will be required to complete a video prescreen to move forward in the hiring process.

Hourly Rate : Up to $26.00 / hour based on experience

At Currance, we believe in recognizing the unique skills and experiences that each candidate brings to our team. Our overall compensation package is competitive and is determined by a combination of your experience in the industry and your knowledge of revenue cycle operations. We are committed to offering a rewarding environment that aligns with both individual contributions and our company goals.

Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, a focus on wellness and support for work-life balance, and more.

Please note that we are looking for people who have hospital billing experience in collections and have some HB billing experience, in high dollar collections, adjustments and denials management.

Job Overview

Resolve complex medical claims. Subject matter expert for account resolution specialists across various payer types. Support financial success of healthcare clients by leveraging expertise to improve processes and outcomes. Drive improvements across all levels of account resolution through mentorship and knowledge-sharing.

Requirements :

Job Duties and Responsibilities

• Execute advanced tasks to drive revenue by resolving complex accounts for clients.
• Address and resolve the high-level escalated or delayed claims, including cases with extensive payer, technical, or clinical review requirements.
• Analyze and resolve high-dollar, high-complexity claims, ensuring compliance with payer-specific guidelines and regulations.
• Mentor all account resolution specialists to elevate skills, focusing on complex cases and strategic approaches.
• Submit claims in accordance with Federal, State, and payer-mandated guidelines, ensuring strict adherence to changing regulations.
• Meet and exceed productivity standards while maintaining high-quality performance in claims resolution.
• Accountable for researching, analyzing, and correcting claim errors and rejections, and implementing strategies to minimize recurrences.
• Maintain expert-level knowledge of payer updates and process modifications, and train staff on critical changes to ensure team-wide compliance and accuracy.
• Investigate, follow up with payers, and resolve outstanding insurance accounts receivables to maximize revenue collection.
• Adjust claims to ensure client accounts accurately reflect the correct liability and balance.
• Lead and contribute to continuous improvement initiatives, identifying trends and opportunities to enhance claim resolution processes.
• Participate in and contribute to daily shift briefings with insights on complex claims and payer trends.
• Other duties and responsibilities as assigned to meet company business needs.

Qualifications

Knowledge, Skills, and Abilities