Currance

General

• Identifies, researches, and ensures timely processing of payments and error corrections, ensuring appropriate documentation of payments, allowances, denial, rejections, are recorded on individual accounts.
• Serve as a subject matter expert responsible for training new and existing team members.
• Provide cross coverage between multiple projects for both hospital and provider-based payment posting.
• Research and resolve payment posting issues, including unidentified payments, missing payments, and payment rejections, communicating with payers, clients, and management, as necessary.
• Ensure compliance with payer regulations and requirements by reconciling payments with remittances, deposits, paper checks, etc.
• Adhere to deadlines for payment posting and reconciliation tasks to ensure timely and accurate financial reporting.
• Maintain thorough and accurate documentation of payment posting activities, including notes on payment discrepancies, adjustments, and resolution efforts.
• Identify opportunities for process improvements and efficiencies within payment posting workflows.
• Provide excellent customer service for clients and management responding promptly and courteously to inquiries related to payment posting and account balances.
• Other duties as assigned.

Payment Poster II

Biller

• Submit hospital medical claims in accordance with federal, state and payer mandated guidelines.
• Research, analyze, and review hospital claim errors and rejections and make applicable corrections.
• Ensure proper hospital claim submission and payment through review and correction of claim edits, errors, and denials.
• Maintain required knowledge of payer updates and process modifications to ensure accurate claims.
• Investigate, follow up with payers, and work claims as assigned.
• Determine reason for non-covered charges and take appropriate action.
• Perform posting billing adjustments.
• Ensure billing reroutes are worked timely and comply with company procedures.
• Escalate stalled hospital claims to manager.
• Identify and communicate payer specific issues to the team and leadership.
• Participate and contribute to daily shift briefings.
• Comply with productivity standards while maintaining quality levels.
• Receptive to feedback and continual performance improvement, and willingness to grow and learn.
• Punctual, dependable, and adapt easily to change.
• Strong character by demonstrating accountability and responsibility.
• Perform work duties using ethical decision-making processes.
• Other job duties as assigned.

Biller III

• Prepare and submit billing data and medical claims (hospital and physician) to insurance companies in accordance with federal, state, and payer mandated guidelines
• Comply with productivity standards while maintaining quality levels
• Ensure proper hospital claim submission and payment through review and correction of claim edits, errors, and denials
• Investigate, follow up with payers, and work claims as assigned
• Perform posting billing adjustments
• Ensure billing reroutes are worked timely and comply with company procedures
• Conduct duties in a professional and timely fashion
• Achieve maximum reimbursement for services provided
• Punctual, dependable, and adapt easily to change

Biller II

Medical Billing and Coding

• Execute tasks focused on revenue generation through account resolution for any company client.
• Review documentation to support or contest payer coding decisions for multiple facilities.
• Prepare clear, concise, and well-supported appeals where applicable, using all available documentation, coding guidelines, and regulatory references to defend billed claims and secure reimbursement on insurance accounts receivable.
• Investigate the root causes of denials and downgrades, as needed.
• Provide targeted training on coding practices to Currance team members, promoting accuracy, compliance, and efficiency in resolving coding-related issues.
• Participate in daily shift briefings and contribute actively.
• Resubmit corrected claims according to Federal, State, and payer-mandated guidelines.
• Research, analyze, and correct claim errors and rejections to ensure accurate resubmission and to avoid payer denials due to preventable errors.
• Escalate problematic accounts, recurring issues, or trends to Supervisor and recommend education or denial prevention measures to the client.
• Stay current on payer updates, process changes, and coding guidelines to maintain compliance with Federal, State, and payer requirements.
• Meet productivity standards while maintaining quality output.
• Communicate payer-specific issues to the team and management for timely resolution.
• Engage in continuous learning to remain up to date on coding and payer policies.

Denial Resolution Specialist

• Independently manage high-dollar, high volume, and complex accounts with significant financial impact.
• Submit accurate medical claims in compliance with federal, state, and payer-specific requirements.
• Resolve multi-level denials that require advanced research, payer escalation, and detailed follow-up.
• Investigate and follow up with payers to collect insurance accounts receivables.
• Prepare and submit first- and second-level appeals with complete supporting documentation, ensuring thorough tracking and follow-up to maximize reimbursement.
• Execute and oversee EHR workflows in systems such as Epic, Cerner, Meditech, and Allscripts, including reroutes, denial closures, and account adjustments.
• Review Explanation of Benefits (EOBs) to resolve payment discrepancies, claim denials, and contractual underpayments.
• Complete rebills and corrections to maximize reimbursement.
• Transforming revenue cycle differently. Improving healthcare together.
• Analyze discrepancies in payments and take corrective actions as needed.
• Meet productivity benchmarks while maintaining high-quality standards.
• Research, analyze, and correct errors and rejections, identify root causes, and implement preventive solutions.
• Verify and adjust claims to ensure accurate client liability and account balance.
• Stay informed about changes in payer guidelines and processes for accurate claim submissions.
• Identify payer trends impacting reimbursement and bring findings to management for review.
• Participate in daily shift briefings and contribute as needed.

Account Resolution Specialist III

Operations

• Supervise the daily operations of a non-exempt hospital billing staff
• Oversee the development, implementation, and achievement of operational goals for clients and the company
• Ensure adherence to client policies and procedures and perform all assigned job-related duties
• Facilitate interviewing of potential billing candidates and provide pre-hire feedback
• Ensure team member compliance with HIPAA, State and Federal laws and guidelines
• Ensure team members comply with productivity standards while maintaining quality levels
• Review quality audits weekly and provide coaching for improvement
• Review team member performance daily and provide coaching if not meeting key metrics
• Escalate employee deficiencies to leadership if coaching attempts have failed
• Report and discuss team member and team progress with leadership
• Perform disciplinary counseling and implement Employee Success Plans as needed
• Promote teamwork, collaboration, and a positive work environment
• Responsible for team member payroll accuracy and approval
• Complete performance evaluations of staff
• Continuous training, mentoring, and development of team members
• Responsible for researching, analyzing, and reviewing claim errors and rejections for trends and improvements
• Stay current with payer updates and process changes to ensure accurate claims resolution
• Ensure adjustments are accurate, timely, and compliant with client policies and procedures
• Identify payer-specific issues and communicate to team and leadership
• Research problem accounts as needed
• Lead and contribute to daily shift briefings
• Escalate client issues (including IPO issues) to leadership if not resolved internally
• Responsible for training all new hires on client and company workflows
• Collaborate with leadership to develop policies, procedures, and job aids
• Participate in client, payer, and internal meetings as requested
• Complete all assigned projects in a timely manner
• Possible limited travel
• Perform other duties as required

Operations Supervisor – Billing HB, PB

• Supervises billing leadership and staff, including hiring, training new team members, performance evaluation, workload allocation, and professional development.
• Serves as the department’s subject matter expert on coding and billing processes.
• Serves as the subject matter expert for each project’s clearinghouse and advises best practices within the client’s clearinghouse.
• Responsible for reviewing improvements with clients pertaining to billing and DNFB recommendations.
• Responsible for reviewing, advising, and building clearinghouse edits and bridge routines to ensure industry standard clean claim rates.
• Ensure compliance with HIPAA, State, and Federal laws and guidelines among team members.
• Implement audit and productivity standards to uphold compliance across the billing teams.
• Ensure leadership teams are informed proactively pertaining to client billing issues and opportunities; attend client meetings as needed for explanations.
• Strive to meet or exceed all KPIs and goals.
• Coach and mentor supervisors when employees do not meet expectations.
• Design, implement, and maintain billing best practice workflows and policies.
• Foster teamwork and a positive working environment.
• Support supervisors with team member payroll accuracy and approvals as needed.
• Participate in client or internal meetings as requested.
• Complete all assigned projects promptly.
• Perform other related duties as needed.

Operations Manager – Billing

• Lead interviews for potential Posting staff and Team Lead candidates.
• Ensure team members consistently comply with HIPAA, state, and federal laws and guidelines.
• Provide ongoing training and mentorship to staff.
• Monitor productivity standards and quality, ensuring all team members meet expectations.
• Review team member quality and coach and mentor team on any negative trends.
• Assess team member performance daily and provide coaching if key metrics are not achieved.
• Escalate employee deficiencies to management if coaching does not result in improvement.
• Communicate team and individual progress with the Shared Services Manager.
• Administer disciplinary actions and implement Employee Success Plans as needed.
• Promote a positive work environment and encourage teamwork.
• Ensure the accuracy and approval of team member payroll.
• Complete performance evaluations for all staff.
• Track and resolve outstanding monies/EOB’s that can’t be posted.
• Ensure client policies around denial posting, contractual write offs etc. are followed.
• Stay up to date with payer updates and process changes to ensure accurate posting.
• Lead and participate in daily shift briefings.
• Investigate problem accounts as identified.
• Escalate unresolved client IPO issues to management.
• Train all new hires on both client and Currance workflows.
• Collaborate with management to develop policies.
• Participate in limited travel as required.
• Complete all assigned projects in a timely manner.
• Perform additional duties as needed.