Account Resolution Specialist III
Remote · California, United States or Arizona, United States
Job Summary
Senior AR/Accounts Resolution Specialist III in a fully remote, Epic-focused Medicare-heavy environment. Independently manage high-dollar, high-volume accounts; resolve complex denials through payer escalation and appeals; navigate Epic for claims review, corrections, and rebills. Focus on Medicare and government payers, with strict productivity (115% daily goal) and quality standards (95% QA) in MST time zone. Responsibilities include researching and correcting errors, rebilling, EOB review, and ensuring accurate client liability while aligning with payer guidelines. Requires strong analytical skills, payer knowledge, and ability to work autonomously in a high-volume client setting.
Required Qualifications
- Epic system expertise required for daily navigation of Epic for claims review, corrections, rebill actions, and account research
- Medicare and Government payer focus with timely filing, RTP/DDE familiarity, and payer denial overturn strategies
- Advanced A/R resolution skills including investigating aged accounts, payer rejections, secondary billing when needed, and adherence to client SOPs
- Ability to work independently while meeting productivity and quality goals
- Experience with EHR workflows in Epic, Cerner, Meditech, Allscripts (reroutes, denial closures, account adjustments)
- Experience with reviewing EOBs to resolve payment discrepancies and contractual underpayments
- Ability to prepare and submit appeals with complete supporting documentation and thorough follow-up
- Knowledge of payer guidelines and processes for accurate claim submissions
- Strong analytical skills and problem-solving abilities
- Detail-oriented with focus on compliance and quality metrics
- Experience with payer trends analysis and communication with management
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