Claims Denial Management Rep

Medix; Easton (Northampton County); On-site; USD 30,000 - 32,000; Full time

Job summary

Medix in Easton, PA is hiring a Claims Denial Management Rep to strengthen our healthcare revenue cycle. You will manage insurance AR, follow up on denials, and ensure timely posting of payments.

Ideal candidates have 2+ years in healthcare A/R, medical billing, or collections, plus familiarity with ICD-10, CPT codes, and CMS-1500 forms. Onsite work, with daily hours 8am–5pm, Monday–Friday.

Qualifications

• High School Diploma or equivalent required.
• 2+ years healthcare A/R, medical billing, or medical collections experience.
• Experience with ICD-10, CPT codes, modifiers, CMS-1500 forms.
• Experience with medical billing software or EMR (NetHealth, Casamba, Optima).
• Proficiency with Excel and MS Office; strong communication skills.

Responsibilities

• Prepare, review, and submit clean claims to commercial insurers, Medicare and Medicaid.
• Monitor aging reports and follow up on outstanding accounts.
• Research and resolve denied, rejected, and underpaid claims.
• Audit patient/billing documents for coding/billing accuracy.
• Post and reconcile daily ERAs, checks, and other payments.
• Communicate billing questions with patients, families, and facilities.
• Collaborate with clinical staff to resolve documentation issues.
• Maintain accurate account records and HIPAA compliance.
• Identify opportunities to improve billing and collections workflows.

Skills

Attention to detail

Communication skills

Time management

Problem-solving

Independent worker

MS Office - Excel

Education

High School Diploma or equivalent

Tools

NetHealth

Casamba

Optima

Job description

Claims Denial Management Rep (254055) Easton, Pennsylvania

Salary: USD22 - USD23 per hour

Schedule

Monday-Friday, 8:00 AM-5:00 PM

Work Setting

Onsite - Easton, PA

Position Overview

We are seeking a detail-oriented and proactive Claims Denial Management Rep to join our healthcare revenue cycle team. This position will play an important role in maintaining the financial health of the organization by managing insurance accounts receivable, following up on outstanding claims, resolving denials, and ensuring timely and accurate payment posting.

The ideal candidate will have 2+ years of healthcare A/R, medical billing, or medical collections experience, a strong understanding of insurance reimbursement guidelines, and excellent communication skills. Experience with physical, occupational, or speech therapy billing is highly preferred.

Key Responsibilities

Prepare, review, and submit clean claims to commercial insurance carriers, Medicare, Medicaid, and facility partners.

Monitor aging reports and proactively follow up on outstanding accounts to expedite reimbursement.

Research and resolve denied, rejected, and underpaid claims through claim review, corrections, appeals, and documentation.

Audit patient and billing documentation to identify and correct coding or billing discrepancies.

Accurately post and reconcile daily ERAs, checks, credit card payments, and other payments.

Communicate with patients, families, and facility administrators regarding billing questions, statements, payment plans, and account discrepancies.

Work closely with clinical therapists and directors to resolve documentation issues, diagnosis/ICD-10 errors, and other billing concerns.

Maintain accurate account records and follow established revenue cycle procedures.

Protect confidential patient and financial information while maintaining compliance with HIPAA and Medicare/Medicaid requirements.

Identify opportunities to improve billing and collections workflows.

Qualifications

High School Diploma or equivalent required.

2+ years of healthcare Accounts Receivable, medical billing, or medical collections experience.

Physical, occupational, or speech therapy billing experience is highly preferred.

Working knowledge of ICD-10, CPT codes, modifiers, CMS-1500 forms, and Medicare/Medicaid reimbursement.

Experience with medical billing software or EMR systems such as NetHealth, Casamba, Optima, or similar platforms is preferred.

Proficiency with Microsoft Office, particularly Excel.

Strong verbal and written communication skills and professional phone etiquette.

Excellent attention to detail and problem-solving abilities.

Ability to work independently, manage competing priorities, and meet deadlines in a fast-paced environment.

Why Join?

Monday-Friday schedule with consistent 8:00 AM-5:00 PM hours

Opportunity to make an immediate impact on a growing healthcare revenue cycle function

Work closely with clinical and operational teams

Ideal opportunity for an experienced healthcare A/R or medical billing professional looking to take ownership of their work