Claims & Denial Follow-Up, CPT,ICD-10, and HCPCS

Job Type: Full-Time || On-siteWorking Hours: From 4:00 PM till 12:00 AMMUST HAVE A LAPTOP Important Note: This position follows U.S. Eastern Time (ET) working hours. Please apply only if you are available and comfortable working the Eastern Time shift.Position Summary: We are seeking an experienced Claims Specialist to manage claim submission accuracy and lead denial follow-up efforts across our client accounts.This role is responsible for identifying denial trends, working aged claims, and resolving payer issues to maximize reimbursement and minimize revenue leakage.

Key Responsibilities

• Review, correct, and resubmit denied or rejected claims across commercial, Medicare, Medicaid, workers’ comp, and no-fault payers.
• Investigate root causes of denials (coding errors, eligibility issues, authorization gaps, timely filing, etc.) and route corrections appropriately.
• Work aging reports to follow up on unpaid/underpaid claims within timely filing windows.
• Communicate with payers via phone and portals (Availity, Waystar, payer-specific portals) to resolve claim status issues.
• Appeal denied claims with appropriate documentation and payer-specific appeal procedures.
• Monitor claim status in practice management systems (Tebra experience strongly preferred).
• Track and report denial trends by payer, provider, and denial reason to support process improvement.
• Maintain compliance with HIPAA and payer billing guidelines.
• Collaborate with billing team and clients to resolve claim discrepancies.Required Qualifications:
• 2+ years of medical billing experience with a focus on claims follow-up and denial Management.
• Strong understanding of CPT, ICD-10, and HCPCS coding as it relates to claim adjudication.
• Experience working claim denials, rejections, and appeals across multiple payer types.
• Familiarity with clearinghouses and payer portals (Availity, Waystar, or similar).
• Working knowledge of EOBs/ERAs and payment posting reconciliation.
• Strong written and verbal communication skills for payer and client interaction.
• Detail-oriented with strong organizational and time-management skills.

Preferred Qualifications

• Direct experience with Tebra practice management software.
• Experience with workers’ compensation and no-fault claim types.
• Prior experience in a multi-client billing company environment.
• Familiarity with Excel-based reporting for denial tracking and AR management.