Billing Specialist
$60,000–$90,000 year
RemoteUnited States or New York City, New York, United States
Job Summary
Own the full billing lifecycle from EDI payor enrollment through remittance posting and patient collections, serving as the last line of defense against billing blackouts. Drive daily cash flow by monitoring A/R aging, identifying stalled claims, and proactively resolving payor edits, rejections, and denials before they age. Manage EDI infrastructure by ensuring trading partner agreements are executed and tested before go-live dates, while leading the denial management program to build structured workflows and implement upstream fixes. Act as the primary vendor liaison for outsourced billing partners, holding them accountable for SLAs, submission quotas, and KPIs. Monitor denial trends and root causes to reduce denial rates month-over-month, working in lockstep with RCM leadership and outside vendors.
Required Qualifications
- In the Trenches Experience: You have been in the Medical Billing trenches for the past few years
- Interest in stepping into a management role
- Understanding of the intricacies of Medical Billing
- Track record of measurably reducing A/R aging and denial rates
- Experience related to Durable Medical Equipment (DME) billing
- Solid understanding of how Telehealth fits into the DME picture
- Knowledge that a CMS submission requires deep refinement
Desired Qualifications
- Experience in a high-growth HealthTech DME environment
- Ability to help steer outsourced billers
- Experience building protocols from scratch based on proactive research
- High autonomy
- Thrive at the intersection of healthcare operations, claim strategy, and high velocity health tech M&A integration
- Experience leading a team
- Experience fixing the root cause of denials
- Systems-First Mindset: building workflows that prevent the same problem from surfacing twice
- Experience with Automation and SOP's
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