Job Description
Sarnova HC, LLCPosition Title: Medicaid Account Resolution Specialist - Digitech - RemoteLocation: Virtual | United StatesJob DescriptionThe Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri-anim Health Services, Cardio Partners, and Emergency Medical Products. Digitech is a leading provider of advanced billing and technology services to the EMS transport industry. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle. Digitech leverages its proprietary technology to offer fully outsourced services that maximize collections, protect compliance, and deliver results for clients.SummaryDigitech is seeking a highly motivated and detail-oriented Insurance Account Resolution Specialist to manage and resolve insurance claims after submission to commercial insurance carriers. This role is responsible for ensuring timely, accurate, and compliant claim resolution by reviewing pending, denied, or incorrectly paid claims and following through until payment is secured. Success in this role requires strong analytical skills, excellent follow-through, and the ability to manage a high-volume workload in a fast-paced environment.Essential Duties and ResponsibilitiesResearch and resolve outstanding insurance claims, including those that are pending, unable to be released, denied, or paid incorrectly by commercial insurance carriersInvestigate claims placed on hold, identifying root causes, correcting errors, and executing needed follow-up actions to release claims for processingAnalyze insurance denials, determining denial reasons, assessing validity, and completing the appropriate resolution steps such as appeals, corrections, or resubmissionsCommunicate directly with insurance carriers via outbound calls to obtain claim status, clarify discrepancies, and secure detailed explanations for pending or denied claimsPrepare and submit additional documentation requested by insurance carriers to support claim adjudication and ensure accurate processingDraft and submit appeals when necessary, ensuring they are supported by proper documentation, regulatory guidelines, and payer-specific requirementsProcess and manage incoming correspondence, including mail, emails, EOBs, requests for information, and any necessary refundsMaintain accurate, detailed notes in billing systems for all follow-up activities, findings, and next stepsIdentify trends or recurring issues, escalating concerns to supervisors or appropriate internal teams to support process improvementMeet daily productivity and accuracy expectations, contributing to a high-performing team environmentAdditional job duties as assignedSkills/Experience RequiredEducation: High School Diploma or equivalent requiredStrong computer skills, including working knowledge of MS Outlook, Word, and ExcelAbility to type 40 WPM with accuracyProven ability to handle high-volume workloads, prioritize effectively, and meet tight deadlinesExperience in a structured environment where call monitoring, performance metrics, or productivity scoring are used is helpfulStrong verbal communication skills with the ability to remain calm, professional, and effective during phone interactions with insurance carriersExcellent written communication skills for crafting clear, accurate documentation and correspondenceExceptional attention to detail and accuracy in reviewing claims, identifying discrepancies, and documenting findingsHighly organized, self-paced, and capable of managing work independently in a remote environmentDependable, punctual, and accountable, with a willingness to ask questions and seek clarification when neededAbility to independently manage all aspects of the job role including required goals and business practices in a remote environmentPhysical RequirementsAbility to talk, hear, and see clearly to read and interpret informationRegular use of a computer, phone, and standard office equipmentMay be required to travel for business purposesAbility to secure confidential informationPerform all duties in a professional environment free of noise or anything that would create a negative customer experienceOther InformationWork environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential function of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Sarnova is an Equal Opportunity Employer. We offer a competitive salary, commensurate with experience, along with a comprehensive benefits package, including 401(k) Plan. EO/M/F/Veterans/Disabled. Our mission is to be the best partner for those who save and improve patients' lives. Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full,