Billing & Claims Bulldog — Denials & Appeals Expert

Crossroads Health & Cosmetic Center PC; Goshen (IN); On-site; USD 42,000 - 64,000; Full time

Job summary

Crossroads Health & Cosmetic Center PC is seeking a Billing and Claims Specialist to manage all aspects of insurance billing, denials, and appeals for our Goshen, IN practice. You will read contracts, chase underpayments, and push back on payer rules while protecting revenue for on-site operations with potential remote follow-up as digital processes mature.

The ideal candidate has CPC/CPB or CCS credentials, strong CPT/ICD-10 knowledge, and experience with Office Ally and Practice Mate.

Qualifications

• Strong background in medical billing/claims in outpatient settings.
• Experience with CPT/ICD-10/HCPCS, E/M coding and modifiers.
• Certified CPC/CPB or CCS is required; CPMA is a plus.
• Familiarity with payer portals and denials appeals.

Responsibilities

• Review visits codes, submit clean claims to commercial payers.
• Work denials, submit corrected claims, write and win appeals.
• Review payer contracts, monitor payments, flag underpayments.
• Liaise with insurers and support contract negotiations.
• Keep coding guides up to date; monitor payer changes.
• Manage aging reports, patient statements, and payment plans.
• Serve as go-to for patient questions on balances and insurance.
• Process claims via Office Ally and related systems; improve digital workflow.
• Move appeals follow-up and postings from paper to electronic systems.
• Report weekly scorecards and escalate issues to leadership.

Skills

Medical billing/claims

Payer disputes/appeals

Billing software proficiency

Attention to detail

Education

CPC or CPB (AAPC)

CCS (AHIMA)

Tools

Office Ally

Practice Mate

EHR 24/7

Job description

Crossroads Health & Cosmetic Center PC is seeking a Billing and Claims Specialist to manage all aspects of insurance billing, denials, and appeals for our Goshen, IN practice. You will read contracts, chase underpayments, and push back on payer rules while protecting revenue for on-site operations with potential remote follow-up as digital processes mature.

The ideal candidate has CPC/CPB or CCS credentials, strong CPT/ICD-10 knowledge, and experience with Office Ally and Practice Mate.