Medical Billing Specialist (Denial Management)

Job description

## **📌 About Alpaca Health** **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.** ## 🚧 What You’ll Do - 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 ## ## 🧠 Who You Are - 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