Remote Insurance A/R & Denials Specialist

Mindful Support Services; Dallas (TX); Remoto; USD 28.000 - 34.000; Tempo integral

Benefícios oferecidos por esta vaga

Health insurance

PTO days

Paid holidays

401k matching

Life Insurance

Professional development

Resumo da vaga

Mindful Support Services is seeking an experienced claim specialist to independently resolve complex insurance balances, denials, and processing issues across commercial, Medicare, and Medicaid payers. The ideal candidate has 2+ years of hands-on insurance A/R follow-up and direct payer outreach, plus experience with AdvancedMD and payer portals.

This full-time remote role emphasizes ownership of claims from denial through final resolution, with emphasis on Washington Medicaid-related denials

Qualificações

• At least 2 years of direct medical insurance A/R follow-up and claim-resolution experience in a healthcare billing environment.
• Experience working with commercial insurance, Medicare, Medicaid, and managed Medicaid claims.
• Strong written and verbal communication skills, with the ability to communicate professionally and effectively with payer representatives, providers, managers, and internal teams.
• Experience working in an EHR or practice-management system, payer portals, clearinghouse tools, Microsoft Excel, and Outlook.
• Strong attention to detail, organization, follow-through, and documentation habits.

Responsabilidades

• Independently manage outstanding insurance A/R, focusing on denied, rejected, and aged claims.
• Analyze denial reason codes, payer correspondence, eligibility and benefits information, authorization requirements, coding or claim-edit issues, and filing-limit concerns to determine the appropriate next action.
• Submit and track corrected claims, reprocessed claims, reconsiderations, appeals, medical-record submissions, and other payer-required documentation.
• Navigate commercial payer portals and communicate directly with payer representatives to obtain claim status, denial details, payment information, and resolution commitments.
• Communicate claim status, documentation needs, and action items to providers and internal partners in a clear, professional, solutions-focused manner.
• Post insurance payments and adjustments accurately when assigned, including ensuring payment activity aligns with remittance advice and claim-resolution outcomes.
• Maintain thorough, actionable documentation in the EHR (AdvancedMD) and related tracking tools so other team members can easily understand the claim history and next steps.

Conhecimentos

Insurance A/R follow-up

Claim resolution

Payer communication

Microsoft Excel

Outlook

Ferramentas

AdvancedMD

Payer portals

Clearinghouse tools

Outlook

Microsoft Excel

Descrição da vaga

Mindful Support Services is seeking an experienced claim specialist to independently resolve complex insurance balances, denials, and processing issues across commercial, Medicare, and Medicaid payers. The ideal candidate has 2+ years of hands-on insurance A/R follow-up and direct payer outreach, plus experience with AdvancedMD and payer portals.

This full-time remote role emphasizes ownership of claims from denial through final resolution, with emphasis on Washington Medicaid-related denials