Remote Claims Escalation & Denials Appeals Specialist

Northpoint Recovery Holdings, LLC; Meridian (ID); Remote; USD 30,000 - 33,000; Full time

Benefits offered by this job

Subsidized health insurance

Paid time off

Employer-sponsored life insurance

Dental, Vision, Disability options

401(k) savings account

Employee assistance program

Job summary

Northpoint Recovery Holdings, LLC in Remote, ID is seeking a Claims Escalation & Denials Appeals Specialist to manage ongoing collections, denial management and accounts receivable for assigned accounts across insurers. You will work with patients, payers, and Northpoint providers to ensure timely payments and pursue appeals when needed.

The ideal candidate will have solid knowledge of CMS, HMO/PPO, Medicare/Medicaid, and payer requirements, and strong communication skills.

Qualifications

• 2+ years of collections, billing reimbursement, payer relations, or medical Accounts Receivable required.
• Experience with commercial insurance billing, Medicaid, and billing software.
• Proficiency with CPT, HCPCS, ICD-10 codes, and payer denial patterns.
• Knowledge of CMS and third-party payer regulations and guidelines.

Responsibilities

• Perform collections to secure medical claims within 28 days.
• Make outbound calls to insurance companies and use payer portals for resolution.
• Coordinate with payers to ensure timely payments for services.
• Document all payer communications in the billing system.
• Prepare appeals when denials are payer errors.
• Collaborate with Utilization Review for prior authorization and medical necessity.

Skills

Collections

Payer relations

Billing software

CPT/HCPCS/ICD-10

Insurance guidelines

EHR/EMR familiarity

Team collaboration

Tools

KIPU EHR

Clearinghouse

Job description

Northpoint Recovery Holdings, LLC in Remote, ID is seeking a Claims Escalation & Denials Appeals Specialist to manage ongoing collections, denial management and accounts receivable for assigned accounts across insurers. You will work with patients, payers, and Northpoint providers to ensure timely payments and pursue appeals when needed.

The ideal candidate will have solid knowledge of CMS, HMO/PPO, Medicare/Medicaid, and payer requirements, and strong communication skills.