Remote Insurance A/R Specialist – Denials & Appeals

Mindful Support Services; Houston (TX); Remote; USD 28.000 - 34.000; Vollzeit

Benefits dieser Stelle

Health coverage 75%

PTO 15 days

6 paid holidays

401k matching

Life Insurance

Professional development

Zusammenfassung

Mindful Therapy Group seeks an experienced claim specialist to independently resolve complex insurance balances, denials, and claim-processing issues across commercial, Medicare, and Medicaid payers.

This is not an entry-level role. The ideal candidate has at least two years of hands-on insurance A/R follow-up and claim-resolution experience, including direct payer outreach and denial management. The role emphasizes ownership from initial denial to final resolution.

Qualifikationen

• At least 2 years of direct medical insurance A/R follow-up and claim-resolution experience in a healthcare billing environment.
• Hands-on experience working commercial insurance, Medicare, Medicaid, and managed Medicaid claims.
• Strong written and verbal communication skills 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.

Aufgaben

• Independently work outstanding insurance A/R, focusing on denied, rejected, and aged claims (120+ days).
• Analyze denial reason codes, payer correspondence, eligibility/benefits, and filing-limit concerns to determine next actions.
• Submit and track corrected claims, reprocessed claims, reconsiderations, appeals, medical-record submissions, and other payer documentation.
• Navigate commercial payer portals and communicate with payer representatives to obtain status, denial details, payment information, and commitments.
• Communicate claim status and needed actions to providers and internal teams in a professional, solutions-focused manner.
• Post insurance payments and adjustments accurately, aligning with remittance advice and resolution outcomes.
• Maintain thorough documentation in the EHR (AdvancedMD) and tracking tools for team clarity.

Kenntnisse

Medical insurance A/R

Claim resolution

Payer outreach

Denial management

EHR systems

Tools

AdvancedMD

Microsoft Excel

Outlook

Jobbeschreibung

Mindful Therapy Group seeks an experienced claim specialist to independently resolve complex insurance balances, denials, and claim-processing issues across commercial, Medicare, and Medicaid payers.

This is not an entry-level role. The ideal candidate has at least two years of hands-on insurance A/R follow-up and claim-resolution experience, including direct payer outreach and denial management. The role emphasizes ownership from initial denial to final resolution.