Medical Biller – Denial Management Specialist

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TYPE OF WORK

Part Time

SALARY

4.75

HOURS PER WEEK

25

DATE UPDATED

Oct 5, 2026

JOB OVERVIEW

**Medical Biller – Denial Management Specialist**

We are seeking an experienced **Medical Biller / Denial Management Specialist** to join our billing team. This position will primarily focus on identifying, researching, correcting, and resolving **insurance claim denials and rejections**.

**Primary Responsibilities:**
- Review and work insurance claim denials and rejections
- Research denial reasons and determine appropriate corrective action
- Correct claim errors and prepare claims for rebilling
- Work rejected claims, clearinghouse errors, and payer edits
- Review ERA/EOB information and payer denial codes
- Follow up on unpaid and denied claims with insurance companies
- Identify issues involving eligibility, authorization, credentialing, coding, demographics, payer requirements, or claim submission
- Document all follow-up and actions taken
- Escalate issues requiring provider, patient, credentialing, or administrative action
- Track unresolved denials through resolution
- Assist with aging accounts related to denied or rejected claims
- Recognize recurring denial trends and communicate issues to the billing team

**Required Experience:**
- Previous medical billing and/or denial management experience
- Strong experience researching and resolving claim denials and rejections
- Understanding of EOBs, ERAs, CARC/RARC denial codes, claim status, and payer follow-up
- Knowledge of Medicare, Medicaid, and commercial insurance billing
- Ability to identify whether a claim should be corrected/rebilled, appealed, adjusted, or escalated
- Strong attention to detail and documentation skills
- Ability to independently manage a denial workload and follow claims through resolution

**EMR Experience:**
Experience with **Ritten iO** is strongly preferred. Experience with other medical billing/EMR systems will also be considered.

**Preferred Experience:**
- Behavioral health and substance use disorder billing
- Medicaid behavioral health billing
- Medicare and commercial payer billing
- CPT and HCPCS claim review
- Prior authorization-related denials
- Credentialing/enrollment-related denials
- Timely filing and appeal management
- Clearinghouse rejection resolution

**Ideal Candidate:**
We are looking for someone who does more than simply identify a denial. The right candidate can **research the root cause, determine what needs to be corrected, document the action clearly, and follow the claim through rebilling or final resolution.**

Please submit your resume along with a brief description of your medical billing and denial management experience. Please include any experience you have with **Ritten iO, behavioral health billing, Medicaid, Medicare, and commercial insurance plans.**

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