Medical Billing & Denials Specialist -(HR82214)

Sagan World LLC.; New Jersey; Hybrid; USD 17,000 - 22,000; Full time

Job summary

Sagan World LLC. is a rapidly growing behavioral healthcare provider based in New Jersey, delivering telehealth and in-person services including psychiatry, therapy, medication management and autism evaluations (ADOS).

As a fast-scaling organization, it aims for operational excellence and compliant revenue cycle management. The Medical Billing & Denials Specialist will submit clean claims, reduce denials, and maximize reimbursement by handling denials, appeals, and AR follow-up, while

Qualifications

• 3+ years of U.S. medical billing experience.
• Strong CPT/HCPCS/ICD-10 coding knowledge.
• Experience managing denials, appeals and AR follow-up.
• Remote work capability with clear English communication.

Responsibilities

• Submit clean claims with CPT/HCPCS/ICD-10 accuracy.
• Investigate denials, identify root causes, file corrected claims or appeals.
• Manage denial and appeals workflows across payers.
• Follow up on aging accounts receivable to maximize reimbursement.
• Collaborate with clinicians to resolve billing issues.
• Ensure CMS, Medicaid, and payer billing compliance.
• Document claim activity and appeal outcomes in billing systems.
• Monitor denial trends and suggest process improvements.
• Maintain HIPAA compliance and protect PHI.

Skills

U.S. medical billing

CPT/HCPCS/ICD-10

Denials management

Remote work

English communication

Tools

EMR/EHR software

Revenue cycle software

Job description

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What brings you here today?

Medical Billing & Denials Specialist -(HR82214)

• $1,500.00 - $2,000.00 / MonthlyFull timeRemote

Job Title: Medical Billing & Denials Specialist

Location: Remote (Global)

Compensation: 1500 – 2000 USD/month

Work Schedule: Monday-Friday, 9:00 AM to 5:00 PM (EST)

NOTE: INDEPENDENT CONTRACTOR POSITION

About the Company:

Sagan represents a rapidly growing behavioral healthcare provider based in New Jersey. The organization serves patients ages five and older through both in-person and telehealth services, offering psychiatry, therapy, medication management, and autism evaluations (ADOS). As a fast-scaling healthcare organization, the team is committed to operational excellence, regulatory compliance, and delivering outstanding patient care through efficient revenue cycle management.

Position Overview:

The Medical Billing & Denials Specialist is responsible for submitting clean claims, reducing denials, and maximizing reimbursement through effective denial management, appeals, and accounts receivable follow-up. This role partners closely with clinical staff to resolve coding, documentation, and authorization issues while ensuring compliance with payer guidelines.

We’re looking for a detail-oriented revenue cycle professional with strong U.S. medical billing experience who takes ownership of their work, enjoys solving complex billing issues, and thrives in a fast-paced healthcare environment.

Key Responsibilities:

• Review and scrub medical claims for CPT, HCPCS, ICD-10 coding, and modifier accuracy before submission.
• Investigate denied claims, identify root causes, and submit corrected claims or appeals within payer filing deadlines.
• Manage denial and appeals workflows from start to finish across commercial insurance, Medicare, and Medicaid payers.
• Follow up on aging accounts receivable and take appropriate action to maximize reimbursement.
• Collaborate with providers and clinical staff to resolve coding, documentation, authorization, and billing issues affecting claim payment.
• Ensure compliance with CMS, New Jersey Medicaid, and commercial payer billing requirements.
• Accurately document claim activity, payer communications, and appeal outcomes within billing systems.
• Monitor denial trends and recommend process improvements to reduce future claim issues.
• Maintain HIPAA compliance and protect patient health information (PHI).

Qualifications:

• 3+ years of experience in U.S. medical billing, revenue cycle, or denial management.
• Strong working knowledge of CPT, HCPCS, and ICD-10 coding.
• Experience reviewing and applying appropriate billing modifiers to ensure accurate claim submission and payer compliance.
• Demonstrated experience managing denials, appeals, and accounts receivable follow-up.
• Familiarity with CMS, Medicaid, and commercial payer billing requirements; experience with New Jersey Medicaid is a plus.
• Strong analytical skills with the ability to identify the root cause of claim denials.
• Excellent attention to detail and organizational skills.
• Strong written and verbal English communication skills.
• Ability to manage multiple priorities while meeting payer deadlines.
• Comfortable working independently in a remote environment.

Nice-to-Haves:

• CPC (Certified Professional Coder) or equivalent certification.
• Experience in behavioral health or psychiatry billing.
• Experience working with EMR/EHR and revenue cycle management software.
• Familiarity with prior authorizations and medical necessity requirements.
• Intermediate to advanced Excel skills.