Remote Medical Claims Specialist – Denials & Appeals

Hanger Inc; Milwaukee (WI); Remote; USD 25,000 - 36,000; Full time

Benefits offered by this job

8 Paid National Holidays

PTO: Vacation and Sick time

Medical, Dental, Vision Benefits

401k Savings and Retirement Plan

Paid Parental Bonding Leave

Employee Referral Bonus Program

Mentorship Programs

Job summary

Hanger, Inc. seeks a Priority Claims Specialist III to join a remote Centralized Revenue Cycle team. This full-time role concentrates on accurate, timely payments and compliant reimbursement for high-dollar claims.

You will review EOBs, follow up with insurers, handle denials and appeals, document findings, and maintain CPT/ICD-10 knowledge while collaborating with clinics and partners.

Qualifications

• High school education or equivalent.
• 4 years of related experience in payor policies including reimbursement, medical policy, and payor appeal requirements.

Responsibilities

• Identify unpaid, short-paid or denied claims using the billing system.
• Review EOBs and insurer communications for correct reimbursement.
• Follow up with insurers by portal, phone, email or fax.
• Identify billing errors and submit corrected claims.
• Provide timely follow up on accounts until resolved.
• File and follow up on appeals and disputes.
• Communicate AR issues to management and document findings.

Skills

Payor policies

Reimbursement knowledge

MS Office

EHR systems (OPS/NextGen)

Education

High school education or equivalent

Tools

NextGen

OnBase

Job description

Hanger, Inc. seeks a Priority Claims Specialist III to join a remote Centralized Revenue Cycle team. This full-time role concentrates on accurate, timely payments and compliant reimbursement for high-dollar claims.

You will review EOBs, follow up with insurers, handle denials and appeals, document findings, and maintain CPT/ICD-10 knowledge while collaborating with clinics and partners.