Account Resolution Specialist

Summary

Account Resolution Specialist

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

Location: Dallas - Hospital

Monday - Friday

8:00 am - 4:30 pm

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)

Job Description

Account Resolution Specialist

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

Location: Dallas - Hospital

Monday - Friday

8:00 am - 4:30 pm

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)