Priority Claims Specialist III
Hanger, Inc.
Salary
💰 $60,700 - $67,800 per year
Job Level
JuniorMid-Level
About the role
- Review case files and navigate evolving insurance rules and company policies
- Collaborate across teams and with offshore vendors to support billing operations
- Resolve escalated patient concerns and explain financial details clearly
- Manage claim processing, appeals, recoupment procedures, and denial code resolution
- Spot opportunities to improve processes and implement billing best practices
- Support end-to-end lifecycle of claims, including coordinating with carriers and vendors
- Maintain documentation and use EHR/billing software for accurate records
Requirements
- 2+ years experience in a healthcare billing, insurance and/or patient relations role, utilizing electronic health record (EHR) systems and billing software (i.e. AdvancedMD)
- Comprehensive understanding of insurance policies, claim processing, appeals, and recoupment procedures
- Detailed knowledge of denial language and carrier CARC codes, with end-to-end expertise of the life cycle of a claim
- Ability to apply critical thinking to evaluate complex cases, identify solutions, and make informed decisions
- Previous experience billing and collecting in mental/behavioral health space (preferred)
- Intermediate proficiency with Google Sheets/Excel and tools such as Zendesk/Salesforce (preferred)
- Ability to multitask, prioritize workloads, maintain high attention to detail, and meet tight deadlines
- 2+ years of experience interacting with offshore vendors (preferred)
- Must be US-based (company is US-based remote only) and not reside in California or Washington for this position
- Must be eligible to work in the United States; visa sponsorship status requested on application
