Alpaca Health
Medical Billing Specialist (Denial Management)
2mo ago
WorldwideRemoteai-powered softwarepayer contractingdenial managementclaims processingreimbursement
Manage and resolve denied medical claims to improve revenue cycle performance.
Requirements
- Bachelor’s degree or equivalent experience
- Excellent attention to detail and organizational skills
- Background in a call center or high-call-volume operational role
- At least 3 years of experience in healthcare billing, collections, denials, or revenue cycle management
- Experience working with US-based commercial and government health insurance payers
- Strong understanding of denials, rejections, EOBs, ERAs, and claims reprocessing workflows
- Strong communication and problem-solving abilities
- Comfortable handling payer calls and navigating payer portals
- Proficient in MS Office, billing systems, and operational tools
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment
Other
- Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.
- We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.
- This role is remote. We’re looking for candidates based outside of the United States, but able to work United States East Coast time zones.
- Own rejections, denials, and denied claims workflows from identification through resolution
- Monitor ERA activity daily and perform same-day touches on denials and rejections
- Drive improvements in Net Collection Rate and payer turnaround times
- Manage reprocessing timelines and ensure timely resubmission of corrected claims
- Investigate root causes of denials and coordinate corrective actions across teams
- Work denied, underpaid, and unpaid claims through payer portals, calls, and written appeals
- Track trends in denials by payer, authorization, coding, documentation, or eligibility issues
- Coordinate with billing, credentialing, clinical, and operations teams to resolve revenue barriers
- Maintain accurate denial tracking, follow-up notes, and resolution documentation
- Escalate high-risk or aging denials proactively
- Assist with payer communication via phone, portal, fax, and email
- Support process improvement initiatives to reduce future denials and revenue leakage