Account Resolution Specialist

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
• 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

• Experience managing patient account follow‑up within a revenue cycle environment
• Demonstrated ability to analyze payer denials and determine appropriate next steps for resolution
• Clear understanding of how to execute effective resolution strategies, including preparing appeal letters
• Strong understanding of payer contracts, reimbursement methodologies, and adjustments
• Familiarity with clinical documentation requirements to verify basic coding compliance