Account Resolution Specialist

Our patients are our number one priority! We're committed to giving children back their childhood!

Job Posting Title:

Location:

Additional Posting Details:

Monday - Friday

8:00 am - 5:00 pm

Hybrid (1 day in-office and 4 days working from home)

Job Description:

Duties/Responsibilities

• Review all assigned accounts to ensure that charges and other relevant information are correct and claims are billed within government and third-party payer guidelines 

• Review and resolve credit balances in a timely manner

• Follow-up on all billed claims to ensure timely and accurate payment and disposition of patient accounts

• Verify appropriateness of reimbursement per contractual agreements and resolve discrepancies with payers

• Review payer denial reasons and appeal with supporting documentation for complete reimbursement

• Follow-up with payers and families routinely to provide assistance to expedite payments

• Assist with training and development of account follow-up methods and procedures

Required Skills/Abilities

• Minimum of two years of experience managing patient account follow‑up within a revenue cycle environment (required)

• Demonstrated ability to analyze payer denials and determine appropriate next steps for resolution (required)

• Clear understanding of how to execute effective resolution strategies, including preparing appeal letters (required)

• Strong understanding of payer contracts, reimbursement methodologies, and adjustments (preferred)

• Familiarity with clinical documentation requirements to verify basic coding compliance (preferred)