Senior Medical Billing Specialist

We are seeking an experienced Medical Billing Specialist to support a hospital-based group practice operating across multiple states with a primary focus on Insurance Accounts Receivable under 60 days.

This is not an entry-level role. The ideal candidate has hands-on experience managing early-stage A/R ensuring claims move efficiently through the revenue cycle and identifying and resolving issues before they age into long-term A/R.

This role is critical in a rapidly growing multi-state environment. The candidate must be comfortable supporting new hospital implementations identifying payer setup issues early and ensuring A/R performance remains stable as the organization expands.

This role is focused on prevention not cleanupsuccess is measured by reducing A/R aging before it becomes a >60-day issue.

What Youll Do

• Own and manage Insurance A/R under 60 days ensuring claims are progressing toward timely payment
• Proactively follow up on newly billed claims and early-stage A/R to prevent aging beyond 60 days
• Identify and resolve issues early in the claim lifecycle (e.g. claim rejections missing information enrollment gaps payer-specific requirements)
• Investigate and resolve unpaid or delayed claims across multiple payers
• Proactively research and resolve payer-specific issues including contacting payers when needed
• Track monitor and manage A/R performance across newly onboarded hospitals
• Identify and escalate payer or setup issues early in new hospital implementations
• Develop and maintain tracking tools (Excel or similar) for payer issues A/R trends and potential risks
• Review correct and resubmit rejected or denied claims as needed
• Monitor trends and escalate recurring payer issues to prevent future delays
• Maintain accurate audit-ready documentation of all follow-up activities
• Collaborate with internal teams to improve clean claim rates and reduce A/R aging

Note: While this role may support other billing functions as needed the primary responsibility is early-stage Insurance A/R management and prevention of aging.

Required Experience & Qualifications

Please apply only if you meet the minimum experience requirements below.

• Minimum 2 years of recent experience as described in a hospital-based or large group practice
• Strong experience with Insurance A/R follow-up focused on early-stage accounts (060 days) . Meaning having an understanding of and understanding why claims are being denied and how to fix it.
• Demonstrated experience working with multiple payers (commercial Medicare Medicaid managed care)
• Experience supporting billing operations across multiple states or payer jurisdictions
• Experience supporting new hospital or practice onboarding expansions or implementations strongly preferred
• Working knowledge of payer guidelines claim requirements and reimbursement workflows
• Proven ability to identify issues early problem-solve and drive resolution independently
• Experience communicating directly with payers to resolve complex issues
• Proficiency with EMR and billing software
• Strong Excel skills for tracking and reporting
• Excellent attention to detail organization and follow-through

Key Traits for Success

• Proactive thinker who identifies and resolves issues before they escalate
• Thrives in a high-growth fast-paced multi-state environment
• Ability to independently problem-solve in unstructured situations including deciphering issues without predefined procedures or standard answers
• Strong problem-solver who can navigate new or unfamiliar payer requirements
• Comfortable working independently with minimal oversight
• Persistent and resourceful in resolving complex billing issues
• Ability to build structure tracking and processes in evolving operational environments
• Positive team-oriented mindset with strong communication skills

Education

• A degree is not required if you have relevant medical billing experience
• A degree without hands-on billing experience will not meet the requirements of this role

Compensation:

Salary range: $56000 $68000 annually (commensurate with experience)

This position is onsite Monday - Friday

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