Insurance Specialist

Adaptive Biotechnologies Corp.

. Review and analyze delayed or denied claims to determine root cause based on payer explanation of benefits or remittance advice .

Posted 9/23/2026full-timeRemote • United StatesJuniorMid-Level💰 $23 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in insurance billing processes, denial management, and revenue cycle operations, with a strong focus on problem-solving and analytical skills. Proficient in managing claim follow-ups and ensuring compliance with relevant regulations and policies.

Highest-signal resume keywords

Insurance Billing ProcessesDenial ManagementRevenue Cycle OperationsBilling Systems ProficiencyCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claim AnalysisCoding CorrectionPayer Follow UpDenial Code KnowledgeMedical Necessity RequirementsWorkflow ImprovementData TrackingProblem SolvingAnalytical AbilitiesDetail Orientation

Soft Skills

Excellent CommunicationOrganizational SkillsCritical ThinkingProactive Issue ResolutionAbility to Manage Priorities

Tools & Technologies

Microsoft Office SuiteQuadaxRCM Systems

Industry Keywords

HIPAA CompliancePayer RulesMolecular TestingGenetic TestingSingle-Case Agreements

About the role

Key responsibilities & impact

Review and analyze delayed or denied claims to determine root cause based on payer explanation of benefits or remittance advice
Conduct timely follow up with insurance carriers to clarify claim status, resolve issues, and secure payment
Obtain missing information, correct coding or billing errors, and submit corrected claims or resubmissions
Escalate unresolved or complex claims to Appeal Specialists or management
Research and interpret payer coverage policies, contracts, and medical necessity requirements related to molecular and NGS testing
Document follow up activity, payer communication, and resolution steps within the billing system
Ensure compliance with HIPAA, payer rules, and internal company policies
Collaborate with prior authorization, billing, reimbursement, and client services teams
Communicate with providers and internal stakeholders to resolve claim discrepancies or obtain information
Track claim statuses, denial reasons, resolution timelines, and follow up outcomes
Identify denial and delay trends and help implement strategies to reduce future denials
Provide workflow and process improvement feedback to enhance revenue cycle efficiency
Manage incoming single-case agreements or LOAs and negotiate appropriate reimbursement rates
Provide single-case agreement trends to contracting and payer relations teams
Perform other duties as assigned

Requirements

What you’ll need

High school diploma
2 years of experience in insurance follow up, denial management, medical billing, or revenue cycle operations
Strong knowledge of insurance billing processes, denial codes, and payer follow up workflows
Excellent verbal and written communication skills
Strong problem solving and analytical abilities
Proficiency with billing systems and Microsoft Office Suite
Detail oriented with strong organizational skills
Ability to manage multiple priorities independently in a fast-paced environment
Critical thinker with a proactive approach to issue resolution
Experience with molecular/genetic testing or specialty laboratory billing preferred
Experience using Quadax or similar RCM systems preferred
Adaptive is not currently sponsoring candidates requiring work authorization support for this position

Benefits

Comp & perks

Equity grant
Bonus eligible
Flexible work outside standard hours when necessary, including nights, weekends, and holidays