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 cleanup—success is measured by reducing A/R aging before it becomes a >60-day issue. What You’ll 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 escalation 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 escalation 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 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 (0–60 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 escal ate. 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: $56,000 – $68,000 annually (commensurate with experience) This position is onsite Monday - Friday

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