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About the role
Key responsibilities & impact- Own and work the aged accounts receivable, prioritizing the highest-value and oldest outstanding claims to maximize collection.
- Investigate unpaid, underpaid, and denied claims, determining root cause and pursuing resolution directly with payers.
- Manage the full denials and appeals process, ensuring denials are addressed promptly and appeals are pursued through to outcome.
- Conduct payer follow-up by phone and portal, escalating and documenting each step until claims are resolved.
- Identify and report developing claim issues, denial trends, and payer patterns, escalating to leadership with recommendations.
- Review and manage overpayments, initiate recoupment processes when necessary, and ensure payers post reconciliations appropriately.
- Audit each month in the quarter for missed billing, unacknowledged claims, and aging that requires action.
- Coordinate with providers to write off uncollectable claims only after a thorough appeals and collection effort.
- Provide support with primary and secondary claim submission and payment posting as needed.
- Monitor and address assigned tasks in Lumary, including provider communications.
Requirements
What you’ll need- Collections or accounts receivable experience is required. You have a track record of working aged AR, denials, and appeals - ideally in a medical billing or healthcare RCM setting.
- Strong investigative ability. You dig into the details, ask the right questions, and don't stop until you've found why a claim isn't paying and resolved it.
- Strong understanding of the medical claim lifecycle, denials management, and payer reimbursement processes.
- Confident and persistent in payer follow-up and appeals, with excellent documentation and follow-through.
- Familiarity with ERA/EOB processing and electronic claim submissions.
- Prior experience in Medicaid billing.
- Experience in ABA or behavioral health billing is a plus.
- Detail-oriented with a high level of accountability and a solutions-first mindset, collaborating with senior team members to find resolutions.
Benefits
Comp & perks- Flexibility to work from home and the office - hybrid working environment if based at an office location in Denver, alternatively fully remote if not based near Denver
- Flexible start and finish times - have a routine but on the days you need to book an appointment or finish early, go for it
- Monthly town halls for connection and company alignment
- Monthly dedicated Social Connection days
- Quarterly employee engagement surveys (currently at 82% engagement and trending upwards)
- Internationally growing company working towards a purposeful vision: Empowering sustainable healthcare
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
accounts receivablecollectionsdenials managementappeals processmedical claim lifecyclepayer reimbursement processesERA processingEOB processingelectronic claim submissionsMedicaid billing
Soft Skills
investigative abilityattention to detailaccountabilitysolutions-first mindsetcollaborationpersistencedocumentation skillsfollow-through
