Careers -

Medical Denials & Appeals / A/R Specialist

Integrated Physician Services is seeking an experienced healthcare revenue cycle professional to join our team as a Medical Denials & Appeals / A/R Specialist.

Position Overview

This position is focused on the resolution of medical insurance denials, appeals, reconsiderations, underpayments, and outstanding accounts receivable.

The successful candidate will have hands-on experience working with insurance payers and will be able to independently review a denied or unpaid claim, determine the reason for the denial, research the appropriate resolution, take the necessary action, and follow the account through resolution.

This is not a production coding position. A CPC or other coding certification is not required.

Key Responsibilities

Review EOBs and ERAs to identify denial, payment, and underpayment issues
Research payer policies, claim requirements, and denial reasons
Identify the root cause of insurance denials
Determine whether a claim requires correction, resubmission, reconsideration, or formal appeal
Prepare and submit well-supported appeals and reconsideration requests
Conduct payer follow-up by telephone and through payer portals
Work aged and outstanding A/R through resolution
Follow up on unpaid claims and underpayments
Track appeals, payer responses, and account activity
Maintain accurate documentation in billing and practice management systems
Research recurring denial trends and identify root causes
Communicate recurring issues to internal billing and administrative teams
Recommend process improvements to reduce future denials and improve reimbursement

Required Qualifications

A minimum of 2 years of hands-on experience with medical insurance denials, appeals, payer follow-up, and A/R is required.

Candidates should have:

Strong medical billing and healthcare reimbursement knowledge
Hands-on insurance denial management experience
Experience preparing and submitting appeals and reconsiderations
Experience communicating directly with insurance payers
Experience reviewing EOBs/ERAs
Experience researching payer policies and claim requirements
Experience with A/R follow-up and underpayments
Strong analytical and problem-solving skills
Excellent written and verbal communication skills
Strong organization and attention to detail
Ability to independently manage multiple accounts, follow-ups, and deadlines
Experience using billing, practice management, or revenue cycle systems
Working knowledge of HIPAA and healthcare reimbursement requirements
Proficiency with Excel, Word, email, and common office software

What We’re Looking For

We are looking for someone who can take ownership of a denied or unpaid claim from beginning to resolution.

The ideal candidate can:

Review → Research → Determine Resolution → Appeal/Correct → Follow Up → Resolve

We are particularly interested in candidates who enjoy researching difficult denials, understanding payer requirements, communicating with insurance companies, and finding solutions to get appropriate claims paid.

Local Residency Requirement

This is a fully remote position after training. However, candidates must reside within approximately a 20-minute drive of our local service area in the Vermilion/Lorain County–western Erie County area due to occasional in-person technical support needs.

Regular office attendance is not required.

Candidates must also be authorized to work in the United States.

Compensation & Schedule

Salary: TBD upon hire

Full-time — 40 hours per week

W-2 position

Remote after training

This Position Is Not Production Coding

This position is specifically focused on:

Denials • Appeals & Reconsiderations • Payer Follow-Up • A/R Resolution

Medical billing and coding knowledge is important because the specialist must be able to recognize coding-related denial issues, but production coding is not the primary responsibility of this position.

Application Requirements

Please submit:

Resume
Brief description of your hands-on experience with:
- Medical insurance denials
- Appeals and reconsiderations
- Payer follow-up
- Accounts receivable/A/R

Please do not include any patient information or protected health information (PHI) with your application.

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