AR Research and Resolution Representative

About the role

The AR Research & Resolution Representative is responsible for researching and resolving claims to maximize cash collections, minimize denials and lost revenue, model the organization's values, and work on individual and project denial and claim assignments.

Responsibilities

• Works outstanding insurance or contract claims and resolves claim edits and denials
• Maintains worklists and assignments at acceptable levels based on performance targets, KPI, and quality scores
• Conducts all insurance or contract follow-up aspects, including interfacing with payers, communicating with internal and external business partners by conducting phone calls, and utilizing web-based tools
• Escalates items promptly
• Identifies opportunities to improve department workflows and cross-functional processes
• Serves as an active contributor in team meetings
• Maintains knowledge of current government and carrier regulations relevant to the industry
• Models the core values of the organization
• Performs and assists with other department duties as needed

Requirements

• High school diploma or equivalent
• Experience in medical insurance, billing experience, or equivalent training or education is helpful, but not required

Skills and Abilities

• Knowledge of and skill in using personal computers in a Windows environment, emphasizing basic word processing and data entry onto spreadsheet programs
• Knowledge of medical insurance and its terminology
• Basic knowledge of ICD-10 and CPT codes
• Ability to work independently and as an effective team contributor
• Ability to pay close attention to detail
• Ability to identify, research, and solve problems and discrepancies
• Ability to communicate courteously and professionally
• Ability to maintain confidentiality
• Ability to process assigned duties in an organized manner
• Ability to perform basic mathematical calculations such as adding, subtracting, multiplying, and dividing
• Ability to effectively perform in a multi-task work environment
• Ability to work overtime when needed
• Ability to work effectively in remote settings

Qualifications

Standard office or remote work environment requiring prolonged periods of computer use. May occasionally require lifting files or materials up to 15 pounds. Visual and manual dexterity required for computer and claim documentation work.

Benefits

USACS offers a comprehensive and competitive benefits package designed to support the health, well-being, and financial security of our employees. Benefits may vary based on role, location, and employment status, but generally include:

• Medical, dental, and vision insurance options
• Health savings accounts (HSA) and flexible spending accounts (FSA)
• 401(k) employee and employer contributions
• Paid time off, including vacation, sick leave, and company holidays
• Paid parental leave & family support benefits
• Short-term and long-term disability insurance
• Life and accidental death & dismemberment (AD&D) insurance
• Employee assistance programs & wellness resources

Additional compensation may include bonus eligibility, equity, or other incentive programs, depending on the role. Specific benefit offerings and eligibility will be provided during the hiring process and may be subject to change in accordance with applicable laws and company policies.