Revenue Cycle Account Reimbursement Specialist MF clone

About the role

We are seeking an experienced Revenue Cycle Account Reimbursement Specialist with a strong background in complex denials, appeals, claims follow-up, and reimbursement. Located in Charlotte, NC.

Responsibilities

• Handle complex insurance denials and the majority of appeals
• Prepare and submit first- and second-level appeals and reconsiderations
• Handle “not medically necessary” denials, including second-level appeals
• Work Medicare appeals, including cases progressing to Medicare administrative/judicial hearings
• Follow up on unpaid and underpaid insurance claims
• Research complex claim and reimbursement issues
• Review and interpret EOBs and payer correspondence
• Identify denial, underpayment, and overpayment trends
• Partner with coding, charge capture, insurance verification, reimbursement, and clinical teams
• Help improve workflows and reduce preventable denials

Requirements

• MINIMUM 4 YEARS of complex claims follow-up/revenue cycle experience REQUIRED
• Strong hands-on denials and appeals experience
• Experience with higher-level and second-level appeals
• Knowledge of Medicare, Medicaid, commercial insurance, and HMO/PPO plans
• Ability to interpret EOBs and payer guidelines
• Knowledge of ICD-10, CPT codes, and medical terminology
• ANY medical specialty or payer background is welcome — no specific specialty or payer required
• EMR experience; AthenaHealth is a BONUS
• Strong Microsoft Word and Excel skills

Pay

$22-$28/hour

Schedule

Monday-Friday, 8:00 AM‑5:00 PM; hybrid arrangement: 2 days remote per week after training.