Senior Medical Billing Specialist

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Senior Medical Billing Specialist (2392874)

Senior Medical Billing Specialist (2392874)

This position is National Remote. You’ll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges.

Explore opportunities with American Health Network (AHN), part of the Optum family of businesses. Here, you'll be part of a team that offers quality, affordable care that's backed by a global organization, committed to improving the lives of those we serve. We operate in over 70 medical offices in Indiana and Ohio with 1,200 employees. Our markets are continuing to grow and we're looking for talented individuals who share our passion for quality care to join our team in provider or office positions.

As a health-focused organization, we will empower you with resources that support your work‑life flexibility as well as your physical, emotional and financial well‑being. This is an opportunity to join a team that helps people feel their best and a chance to discover the meaning behind Caring. Connecting. Growing together.

The Senior Biller supports American Health Network physician billing and the collection of third‑party accounts receivable. Under the supervision of the Business Office Supervisor, this role independently researches and resolves complex or aging insurance accounts using medical billing systems, the electronic health record (EHR), and payer websites. The Senior Biller refiles and appeals claims, submits supporting medical documentation, reconciles account activity, and follows unresolved balances through final disposition.

The role also serves as a knowledgeable resource to team members by sharing payer requirements, identifying recurring denial or workflow trends, and supporting consistent billing practices.

This position is full time. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 4:30 pm EST. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of paid training. The hours of training will be likely during normal schedule but my need to shift based on training availability.

• Manage a significant inventory of insurance receivables, including complex, high-dollar, aging, denied, and underpaid physician billing accounts
• Research account history, eligibility, benefits, coding, authorization, medical necessity, claim status, payment activity, contractual adjustments, and payer requirements to determine the appropriate resolution
• Refile corrected claims, prepare and submit appeals, provide additional medical documentation, and complete timely follow-up through final account resolution
• Analyze and reconcile Explanation of Benefits (EOB) information, remittance activity, payer correspondence, physician billing statements, and patient account balances
• Initiate contact with payers, patients, internal partners, and other third parties; negotiate or coordinate appropriate resolution within established authority and guidelines
• Respond to inquiries and correspondence from payers and patients with professionalism, accuracy, and courtesy
• Explain patient financial liability, non-coverage determinations, EOB information, and physician service statements; process payments and payment plans in accordance with established procedures
• Review account activity for accuracy and completeness, identify discrepancies or root causes, and take appropriate corrective action
• Work escalated or technically complex accounts and provide subject‑matter guidance to billing team members as needed
• Support onboarding, peer coaching, and knowledge sharing related to payer…