Senior Billing Specialist
About The Position
Join Denova Collaborative Health as a Senior Billing Specialist, where your expertise in complex medical billing and revenue cycle operations helps ensure clean, compliant claims and maximizes reimbursement. In this advanced role, you will take ownership of high-dollar and complex claims, identify root causes of recurring billing issues, recommend process improvements, and serve as a resource for the billing team. Your knowledge and leadership will directly support our mission of delivering integrated, whole-person healthcare while strengthening the efficiency and quality of our revenue cycle.
Requirements
- High School Diploma or GED required.
- Three or more years of healthcare revenue cycle, medical billing, or claims management experience with demonstrated accuracy and strong performance.
- Experience with Electronic Health Records (EHR) and practice management systems, preferably AMD.
- Advanced knowledge of medical billing, insurance claims, CPT, HCPCS, ICD-10 coding, payer regulations, and reimbursement processes.
- Strong analytical and problem-solving skills with the ability to resolve complex billing issues.
- Ability to identify process improvement opportunities and recommend effective solutions.
- Excellent organizational, communication, and leadership skills.
- Ability to mentor team members while working independently on advanced assignments.
- Commitment to maintaining HIPAA compliance and protecting patient information.
- Must be located in Arizona.
Nice To Haves
- Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field preferred.
- Certified Professional Coder (CPC) strongly preferred.
- HFMA CRCR certification or other relevant healthcare revenue cycle certification is preferred.
Responsibilities
- Manage complex, high-dollar, and aged claims that require advanced billing knowledge.
- Resolve escalated clearinghouse rejections, payer-specific edits, and coordination of benefits (COB) claim issues.
- Process corrected claims and rebill complex claim types while ensuring timely filing compliance.
- Handle specialized billing scenarios including split claims, interim bills, and secondary and tertiary payer submissions.
- Analyze recurring claim edits and rejection trends to identify root causes across payers and claim types.
- Recommend scrub-rule and edit-logic improvements in collaboration with Business Systems Support.
- Validate the effectiveness of scrub-rule updates before implementation.
- Document findings, trends, and financial impact to support continuous process improvement.
- Serve as a subject matter expert for Billing Representatives by providing guidance on payer rules, coding, modifiers, and claim edits.
- Support onboarding and mentor newer team members through informal coaching and knowledge sharing.
- Maintain and update departmental billing procedures, workflows, and job aids.
- Collaborate with leadership and cross-functional teams to improve billing accuracy and operational efficiency.
- Meet advanced productivity and quality standards while managing complex work.
- Participate in and help lead process improvement initiatives.
- Perform other related duties as assigned.
Benefits
- Comprehensive low-cost medical, dental, and vision insurance.
- Generous retirement plan with a 3.5% company match.
- Long and short-term disability options.
- Holiday pay, PTO, and life insurance benefits.
- Employee wellness program.
- Employee discounts.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
