AR Follow-Up Specialist III - Coding and Complex Denials #Full Time #Remote

61st Street Service Corporation; New Jersey; Remote; USD 80,000 - 100,000; Full time

Job summary

A multi-specialty healthcare provider is seeking an AR Follow-Up Specialist III to manage coding denials and support the appeals process. The role is primarily remote but requires Tri-State residency. Candidates should have at least a high school diploma and 2 years of billing experience. Strong communication and customer service skills are essential. This is a full-time opportunity with competitive hourly rates ranging from $27.88 to $36.06.

Benefits

Comprehensive benefits package

Paid Time Off

Healthcare

Qualifications

• 2+ years in a physician billing or third-party payer environment.
• Effective verbal and written communication skills.
• Knowledge of medical terminology and coding preferred.

Responsibilities

• Work with Certified Professional Coders to support appeals.
• Prepare and submit appeals for denied claims.
• Identify patterns in coding-related denials.

Skills

Understanding contracts and insurance benefits

Customer service orientation

Communication skills

Intermediate computer skills

Education

High school diploma or GED

Tools

Epic or other electronic billing systems

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

AR Follow-Up Specialist III - Coding and Complex Denials - Full Time - Remote

Career Opportunities with 61st Street Service Corp

Current job opportunities are posted here as they become available.

Overview

The 61st Street Service Corporation provides administrative and clinical support staff for ColumbiaDoctors. This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties.

This position is primarily remote, candidates must reside in the Tri-State area.

Note: There may be occasional requirements to visit the office for training, meetings, and other business needs.

Opportunity to grow as part of the Revenue Cycle Career Ladder!

Job Responsibilities

• Work closely with Certified Professional Coders (CPCs) to gather documentation, support appeals, and overturn coding-related denials effectively.
• Elevate cases requiring advanced coding review to appropriate CPCs or supervisors as needed.
• Prepare and submit appeals for denied claims, including Letters of Medical Necessity and other supporting documentation, in collaboration with coding professionals.
• Address incoming correspondence related to coding denials and respond timely to ensure prompt resolution.
• Identify patterns in coding-related denials and escalate trends to supervisors to improve processes and reduce future denials.
• Provide input on process improvements and best practices to enhance the efficiency of denial management.
• Assist Assistant Director/Supervisor with monitoring work queues and other assigned duties related to coding and denial follow-up.
• Support the training of new hires, particularly on coding and complex denial workflows.
• Contact insurance companies, patients, or account guarantors via phone, correspondence, and online portals to obtain the status of outstanding claims and submitted appeals.
• Perform demographic and insurance coverage updates on accounts as appropriate, ensuring all corrections are properly documented and billed.
• Address issues related to third-party sponsorship and follow up as needed.

Job Qualifications

• High school graduate or GED certificate is required.
• A minimum of 2 years’ experience in a physician billing or third party payer environment.
• Candidate must demonstrate the ability to understand and navigate contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
• Candidate must demonstrate strong customer service and patient-focused orientation and the ability to understand and communicate insurance benefits explanations, exclusions, denials, and the payer adjudication process.
• Must demonstrate effective communication skills both verbally and written.
• Intermediate proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
• Experience in Epic and or other electronic billing systems is preferred.
• Knowledge of medical terminology, diagnosis, and procedure coding is preferred.
• Previous experience in an academic healthcare setting is preferred.

Compensation

Hourly Rate Ranges: $27.88 - $36.06

Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.

About 61st Street Service Corporation

61st Street Service Corporation is committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a comprehensive Benefits package to eligible employees, including Healthcare and Paid Time Off to promote a healthy lifestyle.

We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.