Responsibilities
- Investigate and resolve insurance claim denials with speed and accuracy—typically 50 to 100 denials daily.
- Partner with payers to resolve issues and secure timely reimbursement.
- Interpret LCD/NCD requirements and manage CPT/HCPCS-related denials.
- Coordinate with front desk and authorization teams to reduce delays and optimize collections.
- Provide top-tier phone support to patients, insurance companies, and internal teams.
- Work in payer portals (NaviNet, Availity, Medicare portals, and others) and clearinghouses to ensure efficient claim submission.
- Deliver timely and compliant follow-up to meet revenue cycle goals.
Requirements
- 5+ years’ experience in healthcare billing, claims, or insurance follow-up.
- Strong knowledge of ICD-10, CPT, HCPCS, and payer policy nuances.
- Hands-on experience with Medicare collections for specialty drug coverage, including using Medicare portals and filing determinations and appeals.
- Proven success in collections with Blue Cross payers, including BCBS FL, Independence BC, and BCBS TX preferred
- Experience working with Medicaid and other commercial insurance plans.
- Familiarity with reimbursement regulations, managed care contracts, and denial resolution strategies.
- Detail-oriented with strong analytical and critical thinking skills.
- Proficient in Microsoft Office Suite (Outlook, Teams, Excel, etc.).
- A team player with a proactive mindset and a passion for patient-centered outcomes.
Benefits
- Comprehensive Healthcare – Medical, dental, and vision coverage, including prescription drug plans and telemedicine services.
- Flexible Savings Options – Choose from Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA) to manage healthcare costs.
- Supplemental Protection – Accident, critical illness, and hospital indemnity plans to provide additional financial security.
- Dependent Care FSA – Pre-tax savings for eligible childcare and dependent care expenses.
- 401(k) Retirement Plan – Secure your future with a competitive company match.
- Disability Coverage – Voluntary short-term and long-term disability plans to protect your income.
- Fertility and Family Support – Resources and benefits designed to support fertility care and family planning.
- Life and AD&D Insurance – Financial protection for you and your loved ones.
- Counseling and Wellness Support – Free resources to support emotional, physical, and financial well-being.
- Education Assistance – Tuition reimbursement and certification support to help you grow in your career.
- Continuing Education – Access to a CEU library for ongoing professional development.
- Charitable Giving and Volunteer Program – Matched donations and paid volunteer time off to support causes you care about.
- Employee Referral Bonus – Earn rewards for helping us find top talent.
Work Arrangement
Hybrid
Additional Information
- Note: This is a remote position open to candidates across the U.S. Local candidates may also opt to work from our Brentwood, TN office.
- Pay is based on factors such as market location, job-related knowledge, skills, and experience, and is benchmarked against similar organizations in our size and industry. It is not typical for an individual to be hired at or near the top of the posted range, as compensation decisions depend on the facts and circumstances of each case. In addition to cash pay, full-time regular employees are eligible for 401(k), health benefits, and other company-provided benefits; some of these benefits may also be available to part-time employees.
