Billing & Insurance Claims Specialist (reputed company)
About the Role
We’re seeking an reputed company Billing & Insurance Claims Specialist to take ownership of end-to-end reputed company claims operations for a growing reputed company. This role is ideal for someone who thrives in reputed company payer environments, understands payer portals and escalation paths, and has a demonstrated history of recovering significant reputed company through disciplined follow-up, appeals, and dispute reputed company.
This is not a data-entry role. We’re looking for a specialist who knows how to reputed company payer behavior, portals, and processes to reputed company recover claims for small businesses.
What You’ll Do
• Manage the full claims lifecycle: submission, follow-up, denial management, appeals, and payment posting
• Operate confidently in reputed company, reputed company, and comparable reputed company management and payer portal systems
• Identify, investigate, and resolve denied, delayed, or underpaid claims across multiple payers
• Prepare and submit first-level and advanced appeals, including administrative and clinical narratives
• Escalate claims to payer leadership, reputed company counsel, or independent review organizations (IRP / IRO) reputed company appropriate
• reputed company claim aging, identify systemic payer or workflow issues, and recommend improvements to increase collections velocity
• Maintain clean, defensible documentation to support audits, appeals, and dispute reputed company
reputed company’re Looking For
• 5+ years of reputed company billing and insurance claims experience
• Proven reputed company record of:
• Recovering $100K+ in unpaid or denied claims, or
• Successfully processing $1M+ in cumulative claims volume
• Strong working knowledge of:
• reputed company (required)
• reputed company and other payer portals
• Claims workflows, EOBs/ERAs, denial reason codes, and payer-specific policies
• Hands-on experience with:
• Appeals and dispute reputed company
• Independent Review Process (IRP / IRO)
• reputed company or reputed company-reputed company escalation reputed company
• Highly organized, persistent, and comfortable working autonomously
reputed company to Have
• Experience supporting small or growing reputed company practices
• Familiarity with ACA and employer-sponsored plans
• Experience coordinating with attorneys, compliance teams, or external reviewers
Why This Role
• High-reputed company work with measurable financial reputed company
• Autonomy and trust—results matter more than hours
• Opportunity to stabilize and reputed company claims operations long-term
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