Medical Billing Specialist (Denial Management)

Alpaca Health; United States; Remote; USD 60.000 - 90.000; Vollzeit

Zusammenfassung

Alpaca Health is seeking a Revenue Cycle Denials Specialist to own denials, rejections, and reprocessing workflows from identification through resolution. You will monitor ERA activity daily, perform same-day touches on denials, and drive improvements in net collection rate.

The role requires a Bachelor's degree and 3+ years in healthcare billing or revenue cycle management, with experience handling US payers.

Qualifikationen

• Bachelor's degree or equivalent experience required.
• 3+ years in healthcare billing, denials, or revenue cycle management.
• Experience with US-based commercial and government payers preferred.
• Strong communication and problem-solving abilities required.

Aufgaben

• Own rejections, denials, and denied claims workflows from identification through resolution.
• Monitor ERA activity daily and perform same-day touches on denials and rejections.
• Drive improvements in Net Collection Rate and payer turnaround times.
• Manage reprocessing timelines and ensure timely resubmission of corrected claims.
• Investigate root causes of denials and coordinate corrective actions across teams.
• Work denied, underpaid, and unpaid claims through payer portals, calls, and written appeals.
• Track trends in denials by payer, authorization, coding, documentation, or eligibility issues.
• Coordinate with billing, credentialing, clinical, and operations teams to resolve revenue barriers.
• Maintain accurate denial tracking, follow-up notes, and resolution documentation.
• Escalate high-risk or aging denials proactively.
• Assist with payer communication via phone, portal, fax, and email.
• Support process improvement initiatives to reduce future denials and revenue leakage.

Kenntnisse

Attention to detail

Call center experience

Healthcare billing

Denials/revenue cycle

Ausbildung

Bachelor's degree or equivalent experience

Tools

MS Office

Billing systems

Operational tools

Jobbeschreibung

About Alpaca Health

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.

We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.

This role is remote. We're looking for candidates based outside of the United States, but able to work United States East Coast time zones.

What You'll Do

Own rejections, denials, and denied claims workflows from identification through resolution

Monitor ERA activity daily and perform same-day touches on denials and rejections

Drive improvements in Net Collection Rate and payer turnaround times

Manage reprocessing timelines and ensure timely resubmission of corrected claims

Investigate root causes of denials and coordinate corrective actions across teams

Work denied, underpaid, and unpaid claims through payer portals, calls, and written appeals

Track trends in denials by payer, authorization, coding, documentation, or eligibility issues

Coordinate with billing, credentialing, clinical, and operations teams to resolve revenue barriers

Maintain accurate denial tracking, follow-up notes, and resolution documentation

Escalate high-risk or aging denials proactively

Assist with payer communication via phone, portal, fax, and email

Support process improvement initiatives to reduce future denials and revenue leakage

Who You Are

Bachelor's degree or equivalent experience

Excellent attention to detail and organizational skills

Background in a call center or high-call-volume operational role

At least 3 years of experience in healthcare billing, collections, denials, or revenue cycle management

Experience working with US-based commercial and government health insurance payers

Strong understanding of denials, rejections, EOBs, ERAs, and claims reprocessing workflows

Strong communication and problem-solving abilities

Comfortable handling payer calls and navigating payer portals

Proficient in MS Office, billing systems, and operational tools

Ability to manage multiple priorities and meet deadlines in a fast-paced environment