Medical Billing Specialist

Reports To: Director of RCM
Employment Type: Contractor 40+ hours

We are seeking a Senior Billing Specialist with extensive experience in out-of-network medical billing, pricing appeals, and AR management. Behavioral health billing experience is required, with residential addiction treatment billing experience strongly preferred. You will manage complex claims, negotiate reimbursements, and drive resolutions on underpayments and denials. This role requires strong technical skills, direct communication with U.S. insurers, and a proven track record of success in billing operations.

Key Responsibilities:
Submit and track out-of-network claims for maximum reimbursement.
Aggressively follow up on unpaid, underpaid, and denied claims, with a focus on pricing appeals and dispute resolution.
Negotiate reimbursement rates and escalate claims as needed to achieve payment.
Communicate professionally with U.S. insurance companies by phone and email.
Analyze billing trends and recommend improvements to enhance collections.
Manage claims through billing software, clearinghouses, and payor portals.
Ensure compliance with U.S. medical billing regulations and best practices.

Required Qualifications:
3+ years of U.S. medical billing experience, with a focus on out-of-network claims, pricing appeals, and AR follow-up.
Behavioral health billing experience is preferred. Residential addiction treatment billing experience would be a positive.
Strong expertise in claims submission, denial management, and reimbursement negotiations.
Excellent English communication skills, including comfort handling insurer escalations over the phone.
Availability to call and email insurers during U.S. business hours.
Proficiency in billing software, Excel, and insurer portals.
Reliable internet connection and professional remote work setup.

Application Instructions:

To apply, you must:
Include "I meet the Billing Specialist qualifications" in the subject line.

In the body of your application:
Briefly describe your experience with out-of-network billing, pricing appeals, and AR follow-up.
Include a direct link to your resume (Google Drive, Dropbox, or similar link preferred).
Applications that do not follow these instructions exactly will not be considered.

Work Schedule:
Full-time, Contractor
Monday to Friday
8-hour shift with significant overlap with U.S. business hours