Medical Claims Billing Specialist
7 days ago
Job DescriptionUnder the direction of the Director or Manager of Revenue Cycle Management, the Medical Claims Billing Specialist (Accounts Receivable (AR) Manager) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The AR Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role. Primary Job Duties:Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring.Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives.Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.Collaborate internal teams (Performance, Operations, Sales) as well as care center staff when appropriate.At times, support large care center go lives which may include overnight travel.Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements. Performs Denial analysis utilizing the Trizetto platform.Work directly with practice consultants or physicians to ensure optimal revenue cycle functionalityDrive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals. Other duties as assigned.QualificationsHigh School Graduate3+ years experience in a physician medical billing officeMust understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claimsExperience with major payers such as Anthem, Medicare/Medicaid, United Healthcare, CarefirstAthena EHR experience required Experience supporting medical claims billing in DC/ MD/ VA preferred Advanced Microsoft Excel skills (e.g., pivot tables, VLOOKUP, sort/filtering, formulas) and proficiency in Google Sheets preferredMust comply with HIPAA rules and regulations Experience with Washington payors is preferred.Prior experience in a Rural Health Clinic environment is a plus. The hourly range for this role is $24/hr to $26/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.
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Remote, Oregon, United States Alert Billing Full time $40,000 - $80,000 per yearOur company is growing aggressively and we are looking for experienced medical billing specialists to help serve our clients. This is a work from home opportunity. The focus of this position is working denials and aging in Collaborate MD.Responsibilities Include:Understanding of primary code classifications: ICD-10, CPT and HCPCS. Assign and sequence all CPT...
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Medical Claims Billing Specialist
19 hours ago
Remote, United States Privia Health Full timeJob DescriptionUnder the direction of the Director or Manager of Revenue Cycle Management, the Accounts Receivable (AR) Manager is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing...
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Medical Billing Specialist
2 days ago
Remote, Oregon, United States The Grant Group Full time $52,000 - $104,000 per yearPosition Title: Medical Billing Accounts Receivable SpecialistCompany: The Grant Group (TGG)Department: BillingLocation: RemoteReports To: AR ManagerJoin Our Team as an Accounts Receivable SpecialistIf you're an experienced Accounts Receivable professional in the medical billing field, The Grant Group invites you to bring your expertise to our dynamic and...
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Medical Billing Specialist
4 days ago
Remote, Oregon, United States Ohio Clinical Reasearch Partners, LLC Medic Management Group Full time $42,000 - $52,800 per year**Voted to the 2020, 2021, 2022, 2023, and 2024 Cleveland Plain Dealer Top Workplaces List**Medic Management Group, is an Ohio based health care services entity specializing in providing services including: medical billing, collection recovery, credentialing, coding & auditing, consulting, and practice management., Medic Management Group has a wide variety...
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Medical Billing
3 days ago
Remote, Oregon, United States Kindred Treatment Center Full timeMedical Billing (Behavioral Health) Revenue Cycle Management Specialist (Contract / Outsourced Role) U.S. BASED, preferably in MarylandAbout UsKindred Treatment Center is a compassionate, client-centered behavioral health practice dedicated to providing quality care and operational excellence. We provide a variety of services including therapy, psychiatry,...
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Dental Billing Specialist
6 days ago
Remote, Oregon, United States Triton Medical Solutions Full time $40,000 - $80,000 per yearJob Summary: Triton Medical Solutions is a revenue-cycle management company dedicated to hiring team members who deliver excellence in all they do. We are seeking a highly organized and detail-oriented Dental Billing Specialist to join our team as an Independent Contractor. In this role, you will manage all aspects of the dental billing cycle—from...
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Billing Specialist
5 days ago
Hybrid Remote, United States Denova Collaborative Health Full time $40,000 - $70,000 per yearDescriptionJob Purpose: Join Denova Collaborative Health as a Billing Specialist focused on Claims, where your expertise in claim processing directly contributes to our mission of providing integrated health services. This crucial role involves managing the entire lifecycle of medical billing claims, enhancing our financial operations, and ensuring the...
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Revenue Cycle Billing Specialist
2 hours ago
Remote, Oregon, United States Firstsource Solutions Full timeRevenue Cycle Billing SpecialistDate: Nov 3, 2025Location:Remote, Remote, USRequisition ID: 18394Description:Schedule: 8am to 4:30pmPay: 18/hr-22/hr DOEGENERAL SUMMARY:The goal of the Revenue Cycle Billing Specialist is to successfully collect on aging medical insurance claims.Essential Duties and Responsibilities:File claims using all appropriate forms and...
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Medical Claim Review Nurse
23 hours ago
Remote, United States LanceSoft Inc Full timeJob Tittle: Healthcare - Medical Claim Review NurseLocation: RemotePay Range: $40.00 - $43.39Duration: 6 MonthsJob Description:The initial project will focus on outpatient claims and specific CPT/HCPCS coding.Behavioral health and general outpatient coding review and guidelines, reviewing documentation to support to services provided and ensuring all...
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Remote, Oregon, United States Liberty Mutual Insurance Full time $120,000 - $180,000 per yearDescriptionLiberty Mutual has an immediate opening for a Complex Claims Specialist to join our Miscellaneous Medical Facilities Unit. This is a high‑visibility, hands‑on role for an experienced professional‑liability claims handler with deep Miscellaneous Medical Facilities (MMF) and Long‑Term Care (LTC) facility PL expertise. With minimal...
