AR Follow-Up Specialist III: Coding & Denials Expert

Jobtailor; United States; On-site; USD 38,000 - 65,000; Full time

Job summary

Jobtailor seeks a Medical Billing/Denials Specialist to work with ColumbiaDoctors’ network, focusing on gathering documentation, submitting appeals, and overturning coding-related denials. You will coordinate with CPCs and supervisors to resolve complex cases and improve denial-management processes.

Ideal candidates have 2+ years in physician billing, strong customer service, and proficiency with Epic and MS Office.

Qualifications

• High school diploma or GED required.
• 2+ years in physician billing or third-party payer environment.
• Ability to understand contracts, insurance benefits, exclusions, and billing rules.
• Knowledge of claim forms, HMOs, PPOs, Medicare, Medicaid and compliance regulations.
• Strong customer service and patient-focused orientation.
• Ability to explain insurance benefits, exclusions, denials, and payer adjudication.

Responsibilities

• Collaborate with CPCs to gather documentation and overturn coding-related denials.
• Elevate complex cases to CPCs or supervisors.
• Prepare and submit denials appeals with Letters of Medical Necessity.
• Address correspondence related to denials and respond promptly.
• Identify denial patterns and escalate trends to supervisors.
• Assist in monitoring work queues and other duties.
• Support training of new hires on coding and denial workflows.
• Contact payers, patients, or guarantors regarding outstanding claims and appeals.
• Update demographics and insurance coverage accurately.

Skills

Customer service

Verbal communication

Written communication

Insurance benefits explanations

Documentation accuracy

Process improvement

Medical terminology

Denial adjudication

Education

High school diploma or GED

Tools

Epic

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Jobtailor seeks a Medical Billing/Denials Specialist to work with ColumbiaDoctors’ network, focusing on gathering documentation, submitting appeals, and overturning coding-related denials. You will coordinate with CPCs and supervisors to resolve complex cases and improve denial-management processes.

Ideal candidates have 2+ years in physician billing, strong customer service, and proficiency with Epic and MS Office.