Medical Billing AR Specialist - Appeals & Out-of-Network Expert

Job description

Are you a seasoned Medical Billing AR Specialist with deep expertise in appeals, denial management, and out-of-network claims? We want to hear from you.


We are actively seeking a highly experienced, results-driven AR professional to join our fully remote team. This is not an entry-level role - we are looking for someone who has been in the trenches, knows the system, and has the track record to prove it.

WHAT YOU'LL DO
• Manage and aggressively work AR across multiple specialties
• Lead appeals and denial management for complex and high-dollar claims
• Handle out-of-network billing, including underpaid claim disputes
• Work directly with payers using tools such as Data iSight, Zelis, and Patient Advocacy platforms
• Apply knowledge of the Independent Dispute Resolution (IDR) process and No Surprises Act (NSA) where applicable
• Identify trends in denials and implement strategies to reduce AR and increase collections
• Collaborate with clinical and administrative teams to ensure clean claim submission and follow-up

SPECIALTIES WE SERVE
• Surgical Spine
• Orthopedics
• Pain Management
• Ambulatory Surgery Centers (ASC)
• Laboratory
• Vascular Surgery
• Podiatry
• Plastic Surgery
• Neurosurgery
• Chiropractic
• Acupuncture
• Physical Therapy


REQUIREMENTS
• Minimum 5 years of medical billing AR experience in the specialties listed above
• Proven, measurable track record of reducing AR days and increasing revenue recovery
• Strong background in appeals, denial management, and out-of-network claim resolution
• Experience with underpaid claim disputes and payer negotiation
• Familiarity with Data iSight and Zelis Patient Advocacy - required
• Knowledge of IDR/NSA processes - strongly preferred
• eClinicalWorks (eCW) and/or Modernizing Medicine (ModMed) experience - a plus
• Excellent written communication skills for appeal letter writing
• Self-motivated, detail-oriented, and able to work independently in a remote environment


GROWTH & ADVANCEMENT
We don't just hire great people - we invest in them. High performers will have the opportunity to grow into senior, lead, and management roles as the company expands. If you are looking for a place to build a long-term career, not just fill a position, this is the right opportunity for you.

COMPENSATION & BENEFITS
• Salary: $65,000 - $70,000, based on experience
• Medical Insurance
• Dental Insurance
• 401(k) Plan
• 100% Remote Position
• Clear path for career advancement


If you are ready to bring your expertise to a team that values results and rewards performance, apply today.


To apply, please submit your resume along with a brief summary of your AR reduction accomplishments and appeals experience.