Medical Claims Denial Specialists
- Lake Success, NY
- Contract
- Full-time
We are a fast-growing medical billing organization in the Lake Success area, dedicated to delivering exceptional results for our provider partners. We’re seeking revenue cycle professionals at all levels — whether your expertise is in insurance follow-up, denials recovery, or the broader revenue cycle — who thrive on solving problems and getting claims paid.The Opportunity
Join our collaborative team handling surgical and out-of-network claims, appeals, denials, and overall reimbursement recovery. This role is for professionals who don’t just post charges, but who investigate, analyze, and strategize to ensure maximum payment.Key Responsibilities
- Analyze EOBs for out-of-network and surgical claims to identify underpayments or denials
- Research payer portals and policies to support appeals
- Use past payment history, CPT code research, and carrier guidelines to build cases for reimbursement
- Initiate insurance calls as needed to confirm claim status or policy details
- Track and follow up on appeals to successful resolution
- Utilize Excel for reporting and analysis
- At least 3 years of out of network experience within revenue cycle performing insurance follow-up calls investigating medical claims
- Submitting appeals
- Researching denied claims
- Experience processing surgical claims preferred
- Background processing commercial insurance
- Strong portal and system navigation skills, with the ability to quickly adapt to new technology
- Analytical mindset — able to think through a claim from start to finish and decide the next step
- Proactive problem-solver with initiative to investigate without waiting for direction
- Monday to Friday, 37.5-hour work week
- Choice of shifts: 8:30 a.m. – 5:00 p.m. or 9:00 a.m. – 5:30 p.m.
- Half-hour lunch break