Senior Billing Specialist

We are seeking an experienced Medical Billing Specialist to support a hospital-based group practice operating across multiple states, with a primary focus on Insurance Accounts Receivable under 60 days. This is not an entry-level role. The ideal candidate has hands‑on experience managing early‑stage A/R, ensuring claims move efficiently through the revenue cycle, and identifying and resolving issues before they age into long‑term A/R.

This role is critical in a rapidly growing, multi-state environment. The candidate must be comfortable supporting new hospital implementations
, identifying payer setup issues early, and ensuring A/R performance remains stable as the organization expands.
This role is focused on prevention, not cleanup—success is measured by reducing A/R aging before it becomes a >60-day issue.

• Own and manage Insurance A/R under 60 days, ensuring claims are progressing toward timely payment
• Proactively follow up on newly billed claims and early‑stage A/R to prevent aging beyond 60 days
• Identify and resolve issues early in the claim lifecycle (e.g., claim rejections, missing information, enrollment gaps, payer‑specific requirements)
• Investigate and resolve unpaid or delayed claims across multiple payers
• Proactively research and resolve payer‑specific issues, including contacting payers when needed
• Track, monitor, and manage A/R performance across newly onboarded hospitals
• Identify and elevate payer or setup issues early in new hospital implementations
• Develop and maintain tracking tools (Excel or similar) for payer issues, A/R trends, and potential risks
• Review, correct, and resubmit rejected or denied claims as needed
• Monitor trends and elevate recurring payer issues to prevent future delays
• Maintain accurate, audit‑ready documentation of all follow‑up activities
• Collaborate with internal teams to improve clean claim rates and reduce A/R aging

Note:

While this role may support other billing functions as needed, the primary responsibility is early‑stage Insurance A/R management and prevention of aging.

• Minimum 2+ years of recent experience, as described in a hospital-based or large group practice
• Strong experience with Insurance A/R follow-up focused on early‑stage accounts (0–60 days). Meaning having an understanding of and understanding why claims are being denied and how to fix it.
• Demonstrated experience working with multiple payers (commercial, Medicare, Medicaid, managed care)
• Experience supporting billing operations across multiple states or payer jurisdictions
• Experience supporting new hospital or practice onboarding, expansions, or implementations strongly preferred
• Working knowledge of payer guidelines, claim requirements, and reimbursement workflows
• Proven ability to identify issues early, problem‑solve, and drive resolution independently
• Experience communicating directly with payers to resolve complex issues
• Proficiency with EMR and billing software
• Strong Excel skills for tracking and reporting
• Excellent attention to detail, organization, and follow‑through

• Proactive thinker who identifies and resolves issues before they escalated
• Thrives in a high‑growth, fast‑paced, multi‑state environment
• Ability to independently problem‑solve in unstructured situations, including deciphering issues without predefined procedures or standard answers
• Strong problem‑solver who can navigate new or unfamiliar payer requirements
• Comfortable working independently with minimal oversight
• Persistent and resourceful in resolving complex billing issues
• Ability to build structure, tracking, and processes in evolving operational environments
• Positive, team‑oriented mindset with strong communication skills

• A degree is not required if you have relevant medical billing experience
• A degree without hands‑on billing experience will not meet the requirements of this role

Salary range: $56,000 – $68,000 annually (commensurate with experience)

This position is onsite Monday - Friday