Remote Claims Escalation & Denials Appeals Specialist

northpointrecoveryholdingsllc; Meridian (ID); Remote; USD 30,000 - 33,000; Full time

Job summary

Northpoint Recovery Holdings, LLC is seeking a Claims Escalation & Denials Appeals Specialist to manage ongoing collections, denial management, and accounts receivable for assigned accounts. You will work with patients, insurers, and providers to ensure timely payments and resolve denials to exhaustion or payment.

The ideal candidate has experience in the full billing life cycle, including verifications, pre-authorization, utilization review, appeals, and claims adjudication, with knowledge of

Qualifications

• 2+ years of collections, billing reimbursement, payer relations, or medical Accounts Receivable required.
• Experience in a healthcare or behavioral health system with multiple levels of care preferred.
• Experience working with commercial medical insurance billing, Medicaid, claims submission, and billing software.
• All-in-one practice management, clearing house and billing software required.
• Proficient in navigating through payer portals.
• Must be proficient in CPT, HCPCS, and ICD-10 Codes, DSMS and ASAM criteria, data entry for various third party billing and payers, and their reimbursement and denial patterns.
• Ability to work well in a team environment, triage priorities, delegate tasks, and handle conflict.

Responsibilities

• Perform collections to ensure receipts within 28 days.
• Make outbound calls to insurance companies and use payer portals for claims resolution.
• Coordinate with insurers for timely payment for services rendered.
• Follow billing and collection protocols for accurate reimbursement.
• Review accounts receivable and identify payer issues delaying payment.
• Contact payers to understand denials and needed changes for payment.
• Prepare appeals when denials are payer errors.
• Document all payer correspondence in the billing system.
• Collaborate with Utilization Review for prior authorization/documentation.

Skills

Collections experience

Healthcare billing

Payer relations

Communication skills

Tools

Payer portals

Billing software

Clearinghouse software

CPT/HCPCS/ ICD-10

Job description

Northpoint Recovery Holdings, LLC is seeking a Claims Escalation & Denials Appeals Specialist to manage ongoing collections, denial management, and accounts receivable for assigned accounts. You will work with patients, insurers, and providers to ensure timely payments and resolve denials to exhaustion or payment.

The ideal candidate has experience in the full billing life cycle, including verifications, pre-authorization, utilization review, appeals, and claims adjudication, with knowledge of