Medical Billing Resolution Specialist

📋 Description

• Own end-to-end resolution of rejected, denied, and held claims through final payment.
• Research, correct, refile, and appeal denied claims with proper documentation.
• Medical necessity reviews for continued services with payer criteria.
• Research payer policies and communicate with plans as needed.
• Maintain claim inventories and updates in billing platforms, EHR, and CRM.
• Identify denial trends and recommend process improvements.

🎯 Requirements

• High school diploma or equivalent required.
• Associate degree or related healthcare coursework preferred.
• 2–4 years in medical billing or revenue cycle.
• Experience resolving denied/held claims (eligibility, auth).
• Experience with payer policies and insurer communications.
• Proficiency with EHR, billing systems, CRM or ticketing tools.
• Excel and/or Google Sheets for tracking and reporting.

🎁 Benefits

• Paid time off policies, including winter break.
• 401k matching for retirement.
• Health insurance options for you and family.
• Company-paid life and disability coverage.
• Remote work environment with collaboration.