denial resolution specialist

Jordan Young Institute

<div>Title: AR Follow-up and Denial Specialist
Location: Onsite &ndash; Virginia Beach, VA (Hybrid)
Who we are:
Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering patients with the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing exceptional care while remaining friendly, courteous, and efficient.
Aligned Orthopedic Partners is recruiting an experienced AR Follow-up and Denial Specialist. The ideal candidate is experienced with analyzing and resolving insurance claim denials, correcting errors, and securing accurate reimbursement from payers. This role requires strong analytical, coding, and communication skills, with a focus on denial prevention, timely appeals, and collaboration across the revenue cycle team.
What you will do:
Claims Review &amp; Correction<ul><li>
Review denied and unpaid claims to verify coding and billing accuracy.</li><li>
Correct errors and submit revised claims when necessary.</li><li>
Investigate claims with no payer response to confirm receipt and follow up.</li></ul>
Denial Management &amp; Appeals<ul><li>
Analyze denials and generate effective, well-researched written appeals.</li><li>
Appeal denials through coding review, contract interpretation, medical record review, and direct payer interaction.</li><li>
Maintain detailed knowledge of payer websites and appeal processes for commercial and government payers.</li><li>
Ensure appeals and reconsideration requests are completed accurately and on time.</li></ul>
Trend Analysis &amp; Communication<ul><li>
Identify recurring denial trends or payer policy changes affecting reimbursement.</li><li>
Communicate trends to management and recommend process improvements to prevent reoccurrence.</li><li>
Support and participate in process and quality improvement initiatives.</li></ul>
Collaboration &amp; Education<ul><li>
Confer with coders, billing staff, and revenue cycle managers on coding or claim issues.</li><li>
Provide education to team members on payer policies and denial prevention.</li><li>
Collaborate on special projects and assist management with additional tasks as assigned.</li></ul>
Account Reconciliation<ul><li>
Work assigned follow-up queues, including identification of missing payments, overpayments, and credits on accounts.</li><li>
Document all actions taken in the practice management system.</li></ul>
What you bring to the table:
You are a detail-oriented and dependable professional with a strong grasp of accounts receivable and denial processes. You take ownership of your work, communicate clearly, and consistently meet deadlines in a fast-paced environment. You bring:<ul><li>
Minimum of 3 years&rsquo; experience in a medical billing department (orthopedic or surgical experience strongly preferred).</li><li>
In-depth knowledge of healthcare billing, claims processing, payer follow-up, and appeals.</li><li>
Proficiency with payer websites, Microsoft Outlook, Word, and Excel.</li><li>
Coding knowledge sufficient to process denied claims and support appeals.</li><li>
Strong reasoning, critical thinking, analytical, and mathematical skills.</li><li>
Ability to work independently with high productivity and attention to detail.</li><li>
CPC certification preferred but not required.</li><li>
High School Diploma or GED required.</li></ul>
Equal Opportunity Employer
Aligned Orthopedic Partners is an equal opportunity employer. We promote diversity of thought, culture, and background. We celebrate what makes us different and committed to building a team that represents a variety of experiences. All employment is decided on the basis of qualifications, merit, and business need.</div>

AR Follow-up and Denial Specialist

Innovative RCM LLC

Position SummaryA Medical Accounts Receivable (AR) Specialist is responsible for managing and collecting outstanding insurance balances for healthcare services. This role ensures timely reimbursement, resolves billing issues, and maintains accurate records in compliance with healthcare regulations.Key Responsibilities<ul><li>Review and follow up on unpaid or denied insurance claims</li><li>Investigate and resolve claim denials, rejections, and underpayments</li><li>Contact insurance companies to check claim status</li><li>Maintain accurate documentation of all account activity</li><li>Analyze aging reports and prioritize accounts for follow-up</li><li>Ensure compliance with HIPAA and healthcare billing regulations</li><li>Collaborate with billing, coding, and front-office teams to resolve discrepancies</li></ul>Required Skills &amp; Qualifications<ul><li>High school diploma or equivalent (Associate&rsquo;s or Bachelor&rsquo;s preferred)</li><li>Strong analytical and problem-solving skills</li><li>Excellent communication abilities</li><li>Attention to detail and organizational skills</li></ul>Preferred Qualifications<ul><li>Experience with denial management and appeals</li><li>Knowledge of revenue cycle management processes</li><li>Experience in medical billing, coding, or accounts receivable</li><li>Knowledge of insurance processes (Medicare, Medicaid, commercial payers)</li><li>Familiarity with CPT, ICD-10, and HCPCS codes</li><li>Proficiency with medical billing software and electronic health records (EHR) systems</li></ul>Work Environment<ul><li>Standard full-time schedule</li></ul>Key Performance Indicators (KPIs)<ul><li>Days in Accounts Receivable (AR)</li><li>Claim denial rate and resolution time</li><li>Collection rate / reimbursement rate</li><li>Accuracy of account updates and documentation</li></ul>Pay: $16.00 - $18.00 per hourBenefits:<ul><li>401(k)</li><li>Paid sick time</li><li>Paid time off</li><li>Work from home</li></ul>Work Location: Remote

Accounts Receivable Specialist

ebs ameri

We are seeking a detail-oriented and proactive Customer Support Specialist with 1&ndash;2 years of experience in Medical Billing/Accounts Receivable (AR). The ideal candidate will have strong knowledge of U.S. medical billing processes, along with hands-on experience using billing software and insurance portals. Key Responsibilities:<ul><li>Communicate effectively with billing clients via calls, emails, and meetings</li><li>Act as a bridge between clients and the internal team to ensure smooth operations</li><li>Report client issues and concerns to the internal team and ensure timely resolution</li><li>Communicate internal updates or concerns to clients and follow up for resolution</li><li>Manage and lead client meetings to discuss reports, performance, and ongoing issues</li><li>Maintain accurate documentation of client interactions and issue tracking</li></ul>Requirements:<ul><li>1&ndash;2 years of experience in Medical Billing/AR (U.S. healthcare system preferred)</li><li>Strong understanding of billing workflows, insurance claims, and denial management</li><li>Familiarity with medical billing software and insurance portals</li><li>Excellent verbal and written communication skills</li><li>Ability to multitask, prioritize, and manage client expectations effectively</li><li>Strong problem-solving and coordination skills</li></ul>Job Type: Full-timePay: Rs70,000.00 - Rs120,000.00 per monthWork Location: In person

Customer Support Specialist – Medical Billing / AR

MyOme

<div>
 MyOme&rsquo;s mission is to provide clinically actionable genetic information to patients throughout their lives. We combine clinical-grade whole genome sequencing, advanced AI methods for genome interpretation, and seamless digital tools for doctors and patients to order and access results. Our team is composed of seasoned entrepreneurs, scientists, and operators, and we're backed by top-tier investors.
 
 
 
 Position Overview:
 
 
 
 We are looking for a Billing Specialist to join our Customer Support pod at a pivotal moment in MyOme's growth. You won't be stepping into a fully built billing function &mdash; you'll be shaping it. As the single point of contact for all things billing, you'll own full-cycle revenue cycle management end-to-end, work directly with patients, providers, and internal teams, and build the systems and documentation that prevent issues before they escalate.
 
 
 If you're energized by building playbooks, not following them &mdash; and you want your billing expertise to matter at a company where it will directly impact patient outcomes &mdash; this is the role.
 
 
 
 What You'll Do:Patient-facing billing support:
 
 
 
 
 
 <ul>
 <li>
 Primary point of contact for all patient billing inquiries &mdash; first inquiry to final resolution via phone calls and tickets
 </li>
 <li>
 Educate patients on cost transparency, EOBs, insurance benefits, and financial assistance options in plain, accessible language
 </li>
 <li>
 Handle billing escalations with empathy and urgency
 
 
 </li>
 </ul>
 
 Provider &amp; partner billing support:
 
 
 
 
 
 <ul>
 <li>
 Respond to provider and partner billing questions accurately and promptly
 </li>
 <li>
 Clarify CPT codes, reimbursement policies, and prior authorization requirements
 </li>
 <li>
 Communicate billing updates and policy changes to relevant contacts
 
 
 </li>
 </ul>
 
 Revenue cycle &amp; cross-functional operations:
 
 
 
 
 
 <ul>
 <li>
 Own full-cycle RCM &mdash; claims submission, payment posting, denial management, appeals tracking, and resolution
 </li>
 <li>
 Partner with finance and commercial operations to align billing workflows with organizational goals
 </li>
 <li>
 Identify denial trends and implement SOPs to reduce errors and increase resolution rates
 </li>
 <li>
 Manage escalations between patients, payors, and internal departments
 </li>
 <li>
 Contribute to billing ticket metrics and dashboard reporting
 </li>
 <li>
 Proactively surface ambiguous billing ownership issues before they become blockers
 
 
 </li>
 </ul>
 
 Systems &amp; documentation:
 
 
 
 
 
 <ul>
 <li>
 Own the billing SOP library &mdash; build it, maintain it, and improve it as the company scales
 </li>
 <li>
 Leverage HubSpot and clearinghouse/claims platforms to document interactions and track trends
 </li>
 <li>
 Contribute to AI-assisted deflection workflows for tier-1 billing FAQs
 </li>
 <li>
 Maintain HIPAA compliance; HIPAA/PHI training must be completed within the first 30 days
 
 
 </li>
 </ul>
 
 What You'll Ne
 
 
 ed:
 
 
 
 <ul>
 <li>
 3&ndash;6 years of medical billing and RCM experience &mdash; genomics, clinical laboratory, or precision medicine a significant advantage
 </li>
 <li>
 Deep knowledge of full-cycle RCM: EOBs, CPT/ICD-10 coding, denial management, appeals, prior authorizations, and payer processes
 </li>
 <li>
 Experience working cross-functionally with finance, operations, or clinical teams
 </li>
 <li>
 Familiarity with billing and clearinghouse platforms; HubSpot or equivalent CRM preferred
 </li>
 <li>
 Strong communicator &mdash; equally comfortable explaining a bill to an anxious patient and presenting billing trends to leadership
 </li>
 <li>
 Systems thinker who builds SOPs as a habit, not an exception
 </li>
 <li>
 Comfortable with AI tools and automation &mdash; you see them as a force multiplier, not a threat
 </li>
 <li>
 HIPAA certified or willing to complete certification immediately upon hire
 </li>
 <li>
 Startup or early-stage experience preferred &mdash; you're comfortable building the playbook, not following one
 
 
 </li>
 </ul>
 
 Location, Compensation, and Benefits:
 
 
 
 <ul>
 <li>
 
 Location:
 
 Remote in the US
 </li>
 <li>
 
 Compensation:
 
 Annual base salary range is $70,000 - $90,000, depending on experience and location
 
 
 </li>
 </ul>
 San Francisco Bay Area pay range: $70,000 USD - $90,000 USD
 
 
 
 Benefits:
 
 
 
 <ul>
 <li>
 Comprehensive healthcare coverage (Health, Dental, and Vision)
 </li>
 <li>
 401K
 </li>
 <li>
 Unlimited PTO
 </li>
 <li>
 Professional development opportunities
 </li>
 <li>
 Company-sponsored off-sites and team meals during in-person meetings
 </li>
 <li>
 Direct access to company leadership and the opportunity for career growth
 
 
 </li>
 </ul>
 
 Diversity, Inclusion, and Equal Opportunity:
 
 
 
 MyOme values diversity in all forms. We believe that diverse perspectives drive better science and better patient outcomes. We are an Equal Opportunity Employer committed to creating an inclusive workplace that empowers every individual.
 
 
 
 Why Work at MyOme?
 
 
 
 
 Join us if you:
 
 
 
 <ul>
 <li>
 Want to make an impact at the intersection of healthcare and technology, changing the way people engage with their health at the genetic level
 </li>
 <li>
 Enjoy rolling up your sleeves, taking initiative, and being empowered to lead
 </li>
 <li>
 Value humility, transparency, and collaborative problem-solving
 </li>
 <li>
 Thrive in fast-moving, dynamic environments with smart, driven teammates
 </li>
 <li>
 Appreciate competitive compensation, meaningful equity, and excellent benefits
 
 
 </li>
 </ul>
 Learn More: myome.com
</div>

Billing Specialist

Clinica Family Health & Wellness

<div>As our Accounts Receivable (AR) Collections Specialist you will work with assigned payers and accounts from initiation of one-touch claim submissions through payment resolution, including billing, rebilling/appeals, account resolution and denial management.

You Will:
<ul>
<li>Complete the billing process, scrub and submit clean claims to assigned payers within filing requirements.</li>
<li>Complete AR postings to reflect accurate payments in a timely fashion.</li>
<li>Follow-up on all rejections, denials, and past due accounts to maximize collections.</li>
<li>Research and resolve problems for billing failures and/or re-bills for assigned payers and accounts.</li>
<li>Prepare and complete the deposit process daily from start to finish including copying, tracking, and maintaining accurate files and recording in the General Ledger.</li>
<li>Complete refunds, unclaimed funds, and escheatment process for assigned payers.</li>
<li>Respond to questions and requests for information from customers (internal and external) and work collaboratively with other staff, clients and/or external third-party payers in a courteous, timely, and accurate manner</li>
<li>Complete reporting or other requests as needed.</li>
<li>Ensure Release of Information is up to date for billing.</li>
</ul>
What We Need:
<ul>
<li>High School diploma or equivalent.</li>
<li>Three (3+) years recent accounts receivable/customer service experience in mental healthcare billing and collections, including billing systems, cash receipts, private collections, Medicaid, Medicare, managed care and/or traditional insurance.</li></ul> 


We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace.

As a condition of employment, you will be required to receive the annual influenza vaccine. Accommodation may be requested. 


This position will be posted, at minimum, until 5/28/26 and may remain open until a sufficient candidate pool has been collected.</div>

AR Collection Specialist

PROMD Practice Management

<div><div><div>Benefits:</div>
<ul><li>401(k)</li>
<li>Dental insurance</li>
<li>Health insurance</li>
<li>Opportunity for advancement</li>
<li>Paid time off</li>
<li>Vision insurance</li>
<li>401(k) matching</li>
<li>Flexible schedule</li>
 </ul></div><div><div>Medical Insurance Collection Specialist 
</div><div>ProMD&rsquo;s Revenue Cycle Management division is a rapidly growing medical billing company seeking an experienced Medical Insurance Collection Specialist. This role requires a strong background in medical billing, appeals, insurance verification, and team leadership. We provide comprehensive one-on-one training to ensure success in delivering high-quality billing and collection services for our top-ranked multispecialty medical providers. 
</div><div>Qualifications 
</div><div>Candidates must meet the following requirements: 
</div>Proven experience in medical insurance collection department. 
<ul><li>
</li>Strong knowledge of medical appeal guidelines and insurance verification processes. 
<li>
</li>Proficiency in managing appeals and conducting insurance verification. 
<li>
</li>Strong communication skills (written and verbal). 
<li>
</li>Proficient in Microsoft Excel. 
<li>
</li>Knowledge of medical billing guidelines across multiple specialties, including but not limited to OB/GYN, Cardiology, Gastroenterology, and Primary Care. 
<li>
</li><li>Note: This is not an entry-level position. Prior experience and hands-on medical insurance collection experience are required. 
</li></ul><div>Responsibilities 
</div>Analyze reimbursement procedures and account activity to ensure maximum reimbursement. 
<ul><li>
</li>Review and evaluate denials to determine and implement required actions to overturn denials. 
<li>
</li>Identify denial trends related to assigned clients in efforts to implement corrective actions. 
<li>
</li>Achieve unit daily account average target and work deligently to maintain assigned client's AR below 18%. 
<li>
</li>Utilize insurance portals to appeal denied claims. 
<li>
</li>Focus on payer profiles, contract adherence, and denied claim resolution. 
<li>
</li>Identify problem trends such as incorrect coding, carrier nonpayment patterns, and physician coding inconsistencies. 
<li>
</li>Maintain and promote a positive, and professional work environment while maintaining strict confidentiality. 
<li>
</li>Provide consistent support to clients, management, and team members. 
<li>
</li></ul><div>Benefits 
</div>401(k) 
<ul><li>
</li>401(k) matching 
<li>
</li>Dental insurance 
<li>
</li>Health insurance 
<li>
</li>Vision insurance 
<li>
</li>Life insurance 
<li>
</li>Paid time off 
<li>
</li>Paid holidays 
<li>
</li></ul><div>Job Type: Full-time 
</div><div>Schedule: 
</div>8-hour shift 
<ul><li>
</li>Monday to Friday 
<li>
</li></ul><div>Work Location: On-site / In person</div></div></div>

Insurance Collection Specialist

Macrise Tech Solutions

Accounts Receivable &amp; Denial Management<ul><li>Oversee and manage outstanding insurance claims to help reduce overall Accounts Receivable (AR) balances.</li><li>Perform routine follow-ups on denied claims to ensure timely resolution and optimize recovery outcomes.</li><li>Review Electronic Remittance Advice (ERA) reports to identify recurring denial trends and recommend preventive and corrective actions.</li><li>Prepare, submit, and track appeals for denied or underpaid claims, ensuring all supporting documentation is complete and accurate.</li><li>Investigate payment discrepancies and escalate complex or unresolved issues to the Billing Manager when necessary.</li><li>Maintain accurate and up-to-date AR aging reports, providing regular weekly and monthly performance updates.</li><li>Manage billing and claims for specialized services, including TMS, Spravato, and psychological assessments.</li><li>Partner with the Billing Manager to achieve AR reduction, recovery, and accuracy goals.</li></ul>Patient &amp; Provider Communication<ul><li>Respond promptly and professionally to billing-related inquiries from patients, providers, and internal stakeholders.</li><li>Review and verify patient account information before initiating collections or claim follow-ups.</li><li>Collaborate with providers to resolve claim issues, including coding errors and missing documentation.</li><li>Communicate with insurance payers regarding eligibility, prior authorizations, and network participation.</li><li>Address patient concerns with professionalism and empathy, including processing refunds when applicable.</li></ul>Systems Management &amp; Process Improvement<ul><li>Create, monitor, and resolve billing-related support tickets within the eClinicalWorks (eCW) system.</li><li>Provide guidance and support to team members on AR follow-up strategies and denial resolution workflows.</li><li>Coordinate with U.S.-based billing teams to ensure accurate and timely claim submissions.</li><li>Participate in operational meetings to review performance metrics, analyze trends, and recommend process improvements.</li><li>Stay up to date with payer policies, regulatory requirements, and industry best practices in medical billing and reimbursement.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul>Experience:<ul><li>Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English? (Required)</li></ul>Work Location: In person

Medical Billing & AR Specialist

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