Karing Hearts Cardiology is seeking an experienced Medical Billing Denial & Appeals Specialist to join our business office team. This position is responsible for managing insurance denial tasks, appeals, and outstanding accounts. The ideal candidate will have strong medical billing, coding, insurance follow-up, and patient collections experience and be comfortable researching problems, working with insurance companies, and following accounts through resolution. This is a hands-on position in a midsized, independent medical practice , where your work will have a direct impact on the practice and our patients. Responsibilities Review and work insurance claim denial tasks Research reasons for denial and determine the appropriate resolution Correct and resubmit claims when appropriate Prepare and submit insurance appeals and supporting documentation Follow up with insurance companies regarding outstanding claims and appeals Work older and higher-dollar accounts as appropriate Assist with medical coding and claim preparation, including coding claims accurately for submission based on physician documentation and applicable coding and payer requirements Review claims for coding or billing issues that could result in denials and make appropriate corrections before submission Work closely with the medical coding team to resolve coding-related questions and issues Assist the patient collections team with collecting patient-responsible balances, including contacting patients regarding outstanding balances, answering billing questions, and helping resolve account issues Help distinguish between insurance responsibility and patient responsibility to ensure accounts are handled appropriately Assist with accounts that move between insurance billing and patient collections Identify recurring denial issues and bring them to the attention of leadership Maintain accurate documentation of account activity and follow-up Assist with identifying opportunities to reduce future denials Provide periodic reports on denial activity, outstanding appeals, and recovered revenue Qualifications 2-3+ years of medical billing, insurance follow-up, A/R, denial management, or related revenue-cycle experience Strong understanding of insurance claims and reimbursement processes Experience working Medicare, Medicaid, and commercial insurance claims Experience researching and resolving denied claims Working knowledge of medical coding and claim submission requirements Comfortable communicating with patients regarding balances and billing questions Strong attention to detail and organizational skills Ability to manage multiple accounts and deadlines independently Good written and verbal communication skills Ability to work effectively with a small team Cardiology or other specialty-practice billing experience preferred CPC, CPB, or other billing/coding certification is a plus What We're Looking For We're looking for someone who understands that denial management is more than simply resubmitting claims. You should be able to look at a denial and determine: What was denied? Why was it denied? What needs to be done to resolve it? And how can we keep it from happening again? Experience in a hospital or larger revenue-cycle organization is valuable, particularly if you are looking for an opportunity to take greater ownership of your work in a smaller practice setting. This person should also be comfortable working across the business office , including coding claims for submission and assisting with patient collections when needed. We are looking for someone who is willing to step in, solve problems, and help the team keep accounts moving. Compensation $23-$28 per hour, based on experience and qualifications. About Karing Hearts Cardiology Karing Hearts Cardiology is an independent cardiology practice serving patients throughout Northeast Tennessee. We are a growing practice focused on providing high-quality cardiovascular care while maintaining a strong commitment to our patients, our providers, and our employees.

Pay:

$23.00 - $28.00 per hour Expected hours: No more than 40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance

Work Location:

In person