AR Research and Resolution Representative

Posted Yesterday
Be an Early Applicant
2 Locations
In-Office or Remote
15-27 Hourly
Entry level
Healthtech
The Role
Researches and resolves insurance and contract claims to maximize collections and minimize denials. Performs payer follow-up via phone and web portals, maintains worklists/KPIs, updates SOPs and payer matrices, escalates issues, and supports team and departmental process improvements in a remote setting.
Summary Generated by Built In

Job Posting Closing Date: Open until Filled

Where do you belong?

Your career is more than just a job, it's part of your life. Whether you’re a clinician, or non-clinical professional,  at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

USACS also understands that location is important. We offer  career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture,  outstanding benefits and competitive compensation package is best in class.

Job Description

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

Location: Remote

ESSENTIAL JOB FUNCTIONS:      

  • Performs various complex duties, including, but not limited to, working outstanding insurance or contract claims and resolving 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. Contributes to the development and maintenance of company-wide payer matrices and updates to Standard Operating Procedures
  • 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.

KNOWLEDGE, 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.

EDUCATION AND EXPERIENCE: 

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

PHYSICAL DEMANDS:

  • 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.

Hourly Wage: $14.53 - $26.88

The hourly starting wage is $18.50.

Hourly rate may be determined on several factors including but not limited to knowledge, skills, experience, education, geographical location and requirements stated in job description.

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.

Click the red apply button to submit an application and resume. If you are an USACS employee, please apply via the Jobs Hub in the Workday system.

Skills Required

  • High school diploma or equivalent
  • Knowledge of medical insurance and terminology
  • Basic knowledge of ICD-10 and CPT codes
  • Ability to use personal computers in a Windows environment, including basic word processing and spreadsheet data entry
  • Ability to identify, research, and resolve claim denials and discrepancies
  • Ability to communicate courteously and professionally and interface with payers and internal partners
  • Ability to work independently, as part of a team, and perform in a multitask remote environment
  • Experience in medical insurance or billing (helpful but not required)
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The Company
HQ: Canton, OH
9,276 Employees
Year Founded: 2015

What We Do

Founded by emergency medicine physician groups in Colorado, Florida, Maryland, Ohio and Texas, USACS is the national leader in physician-owned integrated acute care, including emergency medicine, hospitalist, critical care and observation services. USACS provides high-quality care to approximately 7 million patients annually at more than 300 programs and is aligned with leading hospital systems across the country. Visit usacs.com to learn more.

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