Medical Biller – Insurance Denials & A/R Follow-Up | Permanent WFH

We are seeking an experienced Medical Biller with strong hands-on experience in ModMed and a proven background in insurance denial management and A/R follow-up. The primary responsibility of this position will be researching, resolving, and appealing insurance denials to ensure claims are processed and paid accurately and timely.

The ideal candidate is highly detail-oriented, persistent, comfortable researching payer requirements, and confident communicating directly with insurance companies when necessary.

Key Responsibilities

• Manage and work insurance denials within ModMed, prioritizing claims based on age, balance, and denial reason.
• Research denied claims to identify the root cause and determine the appropriate resolution.
• Correct and resubmit claims when appropriate.
• Prepare and submit appeals, reconsiderations, and supporting documentation for denied claims.
• Review EOBs/ERAs to identify denial reasons, payment discrepancies, and payer requirements.
• Perform a smaller volume of no-response/aging claim follow-up, particularly with smaller insurance payers.
• Contact insurance carriers by phone to obtain claim status, payment information, denial details, and resolution requirements.
• Navigate payer websites and online portals to research claim status and payer policies.
• Utilize Google and other online resources to research payer requirements, billing guidelines, denial codes, and claim resolution strategies.
• Maintain accurate and detailed documentation of all claim activity and payer communications.
• Identify recurring denial trends and communicate issues that may require changes to the billing or front-end process.
• Follow up consistently on outstanding claims until resolution.
• Meet established productivity, accuracy, and collection goals.
  
  

Qualifications

• 2+ years of medical billing experience, preferably with a strong focus on insurance A/R and denials.
• Recent hands-on experience with ModMed is required.
• Demonstrated experience working insurance denials and appeals.
• Experience with claim status research and insurance follow-up.
• Comfortable calling insurance companies and navigating payer phone systems.
• Strong understanding of EOBs, ERAs, denial codes, claim corrections, and appeals.
• Strong internet research and Google skills for researching payer requirements and billing guidelines.
• Excellent written and verbal communication skills.
• Strong attention to detail and organizational skills.
• Ability to independently research problems and determine appropriate next steps.
• Ability to manage a high-volume A/R workload while maintaining accuracy.
  
  

Perks

• Permanent Work From Home
• Leave Credits
• Monetary Allowance
• Annual Bonus
• Weekly Paychecks
• Fixed Weekends Off
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary
  
  

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Who are we?

BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.