Job Description
Job DescriptionTRC Talent Solutions is seeking Accounts Resolution Specialists on behalf of their client within the healthcare industry.
Location: Fully remote
Shift: 1st, M-F (EST preferred)
Pay: $19-24/hr (based on experience)
Essential Job Duties & Responsibilities:
• Collect and resolve payments from insurance companies by working with assigned payers and utilizing Policies and Procedures.
• Execute the denial appeals process, including assessing, documenting, and resolving appeals with third-party payers.
• Research and resolve rejected/denied claims and analyze accounts for payment accuracy and contract compliance.
• Work with clinical staff to follow-up and appeal denials.
• Prepare, maintain, and submit required reports.
• Report ongoing payer, department, or contract problems to the Manager or Team Lead.
• Provide feedback and improvement ideas regarding facility, Patient Access, Case Management, HIM, Billing, and payer issues.
• Appeal denials per departmental policies, ensuring correct grammar and spelling.
• Identify contract issues related to denials and delayed adjudication and communicate them to the Manager.
• Transmit required documentation to payers for resolving payments.
• Document all payer contact in the appropriate software system.
• Ensure claims are crossed over to secondary insurances and report delays to the Lead.
• Meet productivity and quality standards in resolving accounts and addressing root causes.
• Contribute to achieving department AR goals.
• Identify system and process improvement opportunities during team meetings.
• Cross-train and assist other staff as needed.
• Share relevant updates and procedure changes with peers and management.
• Maintain patient privacy and confidentiality as required.
• Communicate professionally with patients, families, payers, and colleagues.
• Interact with internal teams (HIM, Revenue Integrity, Patient Access, SBO) to achieve department goals.
• Adhere to department guidelines for breaks, time off, and assignments.
• Operate office equipment and ergonomic workstations.
• Follow JCAHO and regulatory agency rules and procedures.
• Report hardware and software issues to the appropriate source.
• Participate in testing and verification for assigned software applications.
• Perform other duties and comply with all policies, standards, and codes of conduct.
Qualifications & Requirements:
• High school diploma or equivalent required.
• Minimum 2+ years of collections experience preferred.
• Strong problem-solving, analytical, and mathematical skills.
• Excellent communication skills with patients, families, coworkers, and professional offices.
• Basic experience with PC applications.
• Detail-oriented with good organizational skills and the ability to work independently.
• Ability to manage multiple priorities and heavy workloads in a high-stress environment.
• Flexibility to handle other tasks in a dynamic work environment.
• Willingness to demonstrate competency and uphold organizational values (e.g., efficiency, safety, teamwork, compassion, integrity, trust, and respect).
TRC Talent Solutions is proud to be an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.