Billing Denials Specialist

Sarasota Arthritis Center • Sarasota, FL

3d • Remote

About The Position

The Billing Denial Specialist is responsible for proactively reviewing, researching, and resolving insurance claim denials to ensure timely reimbursement and minimize revenue loss for the Practice. This role plays a critical part in the revenue cycle by identifying denial trends, filing appeals, correcting claim issues, and working denials through to resolution.
The ideal candidate is highly organized, detail-oriented, dependable, and able to work independently with minimal supervision. This individual must be a self-starter who takes initiative, remains proactive, and does not require constant direction to manage responsibilities effectively.
This is a fully remote position. Only qualified applicants currently residing in Florida will be considered for employment.

Requirements

• Experience working with commercial insurance, Medicare, Medicaid, and managed care payers
• Strong understanding of medical billing, claims processing, EOBs, appeals, and denial resolution
• Proficiency with Microsoft Office and payer portals
• Ability to manage multiple priorities and meet deadlines.
• Knowledge of HIPAA regulations and ability to maintain confidentiality.
• Strong analytical and problem-solving skills
• Excellent attention to detail and organizational skills
• Self-motivated, proactive, and dependable
• Strong written and verbal communication skills
• Ability to identify opportunities for process improvement and workflow efficiency
• Professional, positive, and team-oriented attitude

Nice To Haves

• Minimum of 3 years of medical billing and denial management experience preferred
• Knowledge of CPT, ICD-10, and HCPCS coding preferred
• Experience with EMR and practice management systems preferred

Responsibilities

• Review denial reports daily and actively work all assigned insurance claim denials to resolution.
• Research denied, underpaid, and rejected claims to determine root cause and appropriate corrective action.
• Submit corrected claims, reconsiderations, and appeals in a timely manner.
• Communicate with insurance carriers regarding claim status, appeals, and reimbursement issues.
• Identify denial trends and escalate recurring payer or workflow issues to leadership.
• Maintain accurate and detailed documentation of all follow-up activities within the practice management system.
• Work collaboratively with billing, coding, authorizations, scheduling, and clinical teams to resolve claim issues.
• Ensure compliance with payer guidelines, billing regulations, and practice policies.
• Prioritize workload effectively to meet productivity and aging goals.
• Follow through on unresolved claims until final determination or payment is received.
• Assist with special revenue cycle projects and additional duties as assigned.
• Other duties as assigned. This job description is not designed to cover or contain a comprehensive list of activities, duties, or responsibilities that are required of the employee. They may change, or new ones may be assigned at any time with or without notice.

Benefits

• 100% employer-paid medical insurance for employees
• 401(k) with company match and employer-funded profit sharing
• Four-day work week (Monday – Thursday), supporting strong work/life balance
• Paid holidays and Paid Time Off (PTO)
• A collaborative, team-oriented culture with strong support and a shared commitment to exceptional patient care

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed