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.

Responsibilities:

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

Qualifications:

Minimum 2+ years of recent experience in hospital-based or large group practice medical billing
Strong experience with Insurance A/R follow-up focused on early-stage accounts (0–60 days)
Understanding of why claims are denied and how to fix them
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 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

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
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: Degree is not required if relevant medical billing experience is present.

Compensation:

Salary range: $56,000 – $68,000 annually (commensurate with experience)

This position is onsite Monday - Friday.

Senior Medical Billing Specialist