Remote Insurance Claims & Denials Specialist

Omega; Oregon; Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

Dental coverage

Vision coverage

401(k) match

Paid time off

Job summary

Omega Healthcare Management Services is seeking a skilled professional for a remote, full-time Denials Management/AR follow-up role. You will work with hospitals and physician practices to resolve outstanding issues, analyze denials, and drive payments across payer systems.

Requirements include 2–3 years’ experience in denials management, HIPAA knowledge, and proficiency in standard office software. The position emphasizes efficiency, accuracy, and ongoing process improvement within a remote

Qualifications

• Knowledge of medical and insurance terminology such as CPT, ICD-9, ICD-10, HCPCS, co-pay, deductible or co-insurance, and full understanding of hospital/physician billing.

Responsibilities

• Work with insurance companies on behalf of hospitals and physician practices to resolve outstanding issues.
• Analyze claims (denial/non-denial) in practice management systems, internal system and direct toward resolution (Payment, Adjustment & self-pay).
• Technical billing and denial follow-up on all assigned payer claims.
• Call Payer (Insurance/ third parties) to resolve claims (denial/non-denial) after review from PMS, internal system & process toward resolution (Payment, Adjustment & self-pay).
• Identify potential process improvements, trends, issues and elevate to Supervisor.
• Be part of initial and all ongoing training sessions to enhance knowledge of RCM processes.
• Resolve complex patient account issues requiring investigation of system timeline comments, payer reimbursements and account transactions.
• Identify trends/payer issues and exacerbate complex payer issues to the Supervisor, as necessary.
• Maintain a working knowledge of client policies and procedures. Follow the Workflow documentation like SOP’s Update tracker, Issue Log and Trend logs.
• Maintain quality standards as determined by management.
• Assist the Manager or Supervisor in working priority reports promptly, effectively, and efficiently.
• Maintain accurate records within a collections database.
• Be a mentor to new employees and assist in their training and development.
• Performs other duties as directed.
• Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Skills

Medical terminology

Denials management

AR follow-up

HIPAA compliance

Microsoft Office

Education

High School diploma or equivalent

Tools

Microsoft Office

ADP

Oracle

E1- Field Employee

Standard

Job description

Omega Healthcare Management Services is seeking a skilled professional for a remote, full-time Denials Management/AR follow-up role. You will work with hospitals and physician practices to resolve outstanding issues, analyze denials, and drive payments across payer systems.

Requirements include 2–3 years’ experience in denials management, HIPAA knowledge, and proficiency in standard office software. The position emphasizes efficiency, accuracy, and ongoing process improvement within a remote