Account Resolution Specialist Self Pay Operations FT 1.0 (80 hrs biweekly) (65168)

In a culture of continuous quality improvement and a commitment to delivering a positive billing experience the Account Resolution Specialist serves as a subject matter expert and liaison. This role is responsible for verifying the accuracy of insurance registration payment and adjustment postings and the effectiveness of the self-pay collection process on behalf of the patient. The specialist evaluates and analyzes data to identify trends and opportunities for process improvement. They consistently demonstrate the Standards of Excellence and always uphold strict confidentiality.

Job Functions:

1. Conduct comprehensive reviews of patient accounts with self-pay balances to identify issues such as payment delays posting inaccuracies untimely insurance submissions and missed discount applications (e.g. uninsured prompt pay charity care).
2. Leverage eligibility coverage discovery tools to identify third-party coverage for patients registered as uninsured.
3. Utilize propensity-to-pay tools to assess potential eligibility for Medicaid or Financial Assistance programs.
4. Collaborate cross-functionally with Patient Access Patient Financial Services Coding Financial Advocates and Medicaid Eligibility vendors to ensure accurate and timely billing.
5. Proactively contact patients to obtain necessary documentation or information required by third-party payers to resolve denied claims (e.g. COB accident details PR227).
6. Identify recurring trends or patterns to develop strategies aimed at preventing future billing issues.
7. Communicate directly with patients via phone email or mail to resolve outstanding account balances.
8. Educate and assist patients regarding billing disputes financial assistance programs payment plans available discounts and HELP Financial contract setup.
9. Assumes all other duties as assigned.

Minimum Education/Experience Required:

• High school diploma or GED required.
• A bachelors degree in healthcare administration business or a related field is preferred.
• Minimum of two years of relevant experience required.
• Experience in healthcare billing or related fields knowledge of health insurance processes policies and procedures preferred.

Special Knowledge Skills Training:

• Strong negotiation and communication skills with the ability to advocate effectively on behalf of patients.
• Excellent attention to detail and analytical skills to review and interpret complex insurance policies and claims.
• Ability to work independently and collaboratively in a fast-paced deadline-driven environment.
• Proficient in using computer systems and software applications related to claims processing and documentation.
• Strong problem-solving skills; strong computer skills; fluent in Excel and PowerPoint; manual dexterity color vision and near visual acuity.

Compensation Details: Education experience and tenure may be considered along with internal equity when job offers are extended.

Benefits: Memorial Health System is proud to offer an affordable comprehensive benefit package to all full time and flex time employees. To learn more about the many benefits we offer please visit our website at

Bonus Eligibility: Available to qualifying full or flex time employees. Eligibility will be determined upon offer.

Memorial Health System is an equal opportunity provider and employer.

If you wish to file a Civil Rights program complaint of discrimination complete the USDA Program Discrimination Complaint Form found online at or at any USDA office or call to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue S.W. Stop 9410 Washington D.C. 20250-9410 by fax or email at.

*Memorial Health System is a federal drug-free workplace. This policy prohibits marijuana use by employees.