Remote AR Denial Specialist — Medical Billing & Appeals

Behavioral Health Network, Inc.; Springfield (MA); Remote; USD 32,000 - 37,000; Full time

Benefits offered by this job

PTO

403(b)

Educational assistance

Medical insurance

Dental insurance

Vision insurance

Employee assistance program

Job summary

Behavioral Health Network, Inc. is seeking an experienced Medical Billing Specialist to support Western Massachusetts-based claims processing and follow-up. The role emphasizes AR management, appeals, and accurate coding within Behavioral Health guidelines.

You will review denials, file appeals, and work with payer systems to ensure timely reimbursements. This is a remote position requiring 8am-4pm Eastern exposure, with comprehensive benefits and professional growth opportunities in a

Qualifications

• Minimum of 5 years in a medical billing department with strong AR account follow-up, appeals, and Behavioral Health codes and modifier knowledge.
• Demonstrated knowledge of and experience in healthcare medical billing, claims processing, follow-up, and appeals.
• Carelogic EHR experience is preferred but not required.

Responsibilities

• Follows up on all assigned claims (at 45 days, 60 days, and 90 days) to ensure timely reimbursement and bring claims to closure.
• Reviews denied claims for accuracy to ensure coding, billing rates, and modifiers are accurate before sending appeals or reconsiderations to payers.
• Investigates claims with no payer response to ensure the payer received the claim.
• Navigates payer websites and appeal processes as defined by all payers including Mass Health, Tricare, Medicare, Medicaid, and Medicare Advantage plans.
• Reviews and finds trends or patterns of denials to prevent errors.
• Assists and confers with the EHR Matrix team and Billing Manager concerning any coding or modifier setup issues.
• Responsible for identifying missing payments, overpayments, and analyzing credits on accounts.
• Initiates refund requests for credit and overpayments.

Skills

AR follow-up

Medical billing

Claims processing

Appeals

HIPAA compliance

Education

High School Diploma or GED

Tools

Carelogic EHR

Job description

Behavioral Health Network, Inc. is seeking an experienced Medical Billing Specialist to support Western Massachusetts-based claims processing and follow-up. The role emphasizes AR management, appeals, and accurate coding within Behavioral Health guidelines.

You will review denials, file appeals, and work with payer systems to ensure timely reimbursements. This is a remote position requiring 8am-4pm Eastern exposure, with comprehensive benefits and professional growth opportunities in a