Claims Processor – Billing Specialist
APS Medical Billing
Job Summary
APS Medical Billing is seeking experienced Medical Billing Specialists to investigate denied claims, perform accounts receivable follow-up, submit appeals, and resolve outstanding insurance balances in a fully remote environment.
Job Description
The Claims Processor – Billing Specialist is responsible for managing unresolved insurance claims and ensuring timely reimbursement for healthcare providers. This position focuses on researching denied claims, performing insurance follow-up, navigating payer portals, submitting appeals, and resolving billing discrepancies.
The role requires strong knowledge of medical billing regulations, insurance reimbursement processes, medical terminology, and accounts receivable workflows. Successful candidates must be highly organized, detail-oriented, and able to manage high-volume claim inventories while meeting productivity goals.
### Key Responsibilities
#### Claims Follow-Up
* Review unresolved insurance claims
* Follow up on outstanding balances
* Monitor claims throughout the billing cycle
* Ensure timely claim resolution
#### Denials Management
* Investigate denied claims
* Research denial reasons
* Prepare and submit appeals
* Resolve reimbursement issues
#### Accounts Receivable
* Perform A/R follow-up activities
* Work aging accounts
* Track claim status updates
* Maintain accurate documentation
#### Insurance Research
* Navigate insurance portals
* Verify claim processing status
* Review payer guidelines
* Research reimbursement requirements
### Requirements
* Minimum 3 years medical billing experience
* Strong A/R follow-up experience
* Experience with UB-04 billing
* Knowledge of medical terminology
* Understanding of reimbursement processes
* Strong computer and typing skills
* Insurance portal navigation experience
### Preferred Skills
* Denials management experience
* Appeals experience
* Government payer knowledge
* Commercial insurance experience
* Multi-state billing knowledge
### Benefits
* Fully Remote
* Monday-Friday
* No Weekends
* PTO
* Medical Insurance
* Dental Insurance
* Vision Insurance
* Life Insurance
* 401(k)
* Paid Holidays
* Employee Assistance Program
### Good Fit For
Medical Billers, AR Specialists, Denials Specialists, Revenue Cycle Specialists, Claims Processors, Insurance Follow-Up Representatives, and Healthcare Billing Professionals.