Billing Specialist

Position Summary 

The Billing AR Representative is responsible for managing and resolving outstanding accounts receivable (AR) for medical/DME claims. This position will proactively work unpaid and underpaid claims, identify and correct billing issues, communicate with insurance payers, submit appeals and reconsiderations, and follow claims through resolution.

The ideal candidate has strong knowledge of medical billing, insurance claims, payer requirements, and AR follow-up, with excellent attention to detail and the ability to work independently in a high-volume environment. 

What You’ll Do 

• Review and work outstanding insurance accounts receivable according to established aging and collection priorities.
• Research unpaid, denied, rejected, and underpaid claims to determine the reason for non-payment.
• Contact Medicare, Medicare Advantage, commercial insurance plans, and other payers to obtain claim status and determine required actions.
• Make outbound insurance calls and navigate payer websites/portals to resolve claim issues.
• Identify billing errors and determine appropriate corrections, rebilling, or claim resubmission requirements.
• Prepare and submit timely appeals, reconsiderations, disputes, and supporting documentation for denied or underpaid claims.
• Review explanation of benefits (EOBs), electronic remittance advice (ERAs), denial codes, payer correspondence, and claim history.
• Research payer policies and contractual requirements to determine appropriate reimbursement and appeal options.
• Identify recurring denial trends and communicate issues to management and/or the billing team.
• Maintain accurate and thorough documentation of all AR activity, including payer calls, claim status, appeal submissions, and follow-up actions.
• Meet established productivity, quality, and collection goals.

What You’ll Bring  

• Medical billing, accounts receivable, insurance follow-up, or claims experience. (1-3 years preferred)
• Knowledge of medical insurance billing and claim processes.
• Ability to communicate professionally with insurance representatives and other healthcare professionals.
• Strong attention to detail and organizational skills.
• Ability to research problems, identify root causes, and determine appropriate solutions.
• Ability to manage multiple accounts and meet deadlines independently.
• Basic computer proficiency and experience working with billing systems and payer portals.
• Experience with DME billing.
• Experience billing Medicare, Medicare Advantage, and commercial insurance plans.
• Experience preparing insurance appeals and reconsiderations.
• Familiarity with HCPCS codes, modifiers, medical necessity requirements, authorizations, and payer-specific billing guidelines

Special Projects

• Performs other related duties and special projects as assigned. Responsibilities may be adjusted periodically to align with organizational priorities, business needs, and company growth.

Travel Requirements

• This is primarily a remote position with minimal travel. Occasional attendance at in-person meetings or team events may be required. Estimated travel: 0-5%

What We Offer:

• Competitive Compensation ($23.00-$26.00 per hour)
• Insurance (Medical/Dental/Vision)
• 401(k) Retirement Savings Plan
• Accrued PTO 
• 13 Paid Holidays
• Monthly Cell Phone Stipend (If Applicable)
• Life Insurance, LTD and STD
• Remote work desk allowance