{"@context":"https://schema.org","@type":"JobPosting","directApply":"https://schema.org/False","title":"Medical Billing/Reimbursement Specialist","description":"

Medical Biller- Denials, Appeals, AR & Insurance Eligibility - Some Payment Posting duties

MUST HAVE MEDENT SYSTEM EXPERIENCE FOR THIS POSITION.

We are seeking an experienced Medical Biller with strong expertise in claims denials and appeals, insurance eligibility, coordination of benefits (COB), and accounts receivable (AR) follow-up. This role is critical to maintaining timely reimbursement and supporting the financial health of our multi-provider practice. This position requires a strong understanding of medical terminology, coding systems, and billing practices within a medical office environment

This ideal candidate is detail-oriented, organized, persistent, and well-versed in the payer rules, compliance standards, and revenue-cycle workflows.

Key Responsibilities:

· Research, resolve, and appeal medical claim denials across all payer types in PA and MI (Medicare, Medicaid, and commercial payers)

· Prepare and submit appeals at all levels including:

o First-level and second-level appeals

o Written appeals and payer phone follow-ups

· Perform insurance eligibility verification, benefits interpretation, and coverage validation

· Identify and resolve coordination of benefits issues, including primary vs secondary payer determination

· Conduct accounts receivable follow up including:

o Insurance AR follow up to ensure timely claim resolution

· Review EOBs and remittance advices to review and resolve denials

· Track AR aging, appeal deadlines, and follow-up activity to ensure timely resolution

· Maintain accurate documentation and detailed notes in the billing system

· Adhere to HIPAA and patient privacy regulations at all times

· Support additional billing functions as needed in a multi-provider specialty practice

Job Type: Full-time

Expected hours: 40 per week

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