Claims Escalation & Denials Appeals Specialist

Northpoint Recovery

. Perform collections to ensure receipt of medical claims within twenty-eight (28) days .

Posted 11/10/2026full-timeRemote • Idaho • United StatesJuniorMid-Level💰 $22 - $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical billing and collections, including proficiency in CPT, HCPCS, and ICD-10 codes, as well as navigating payer portals and managing accounts receivable. Strong understanding of insurance guidelines and the ability to resolve discrepancies and denials effectively.

Highest-signal resume keywords

Medical Billing And CollectionsPayer RelationsCPT, HCPCS, And ICD-10 Codes ProficiencyExperience With Payer PortalsKnowledge Of Insurance Guidelines

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CollectionsBilling ReimbursementAccounts Receivable ManagementClaims SubmissionData EntryProblem-SolvingDocumentationAppeals PreparationReimbursement Patterns AnalysisMultitasking

Soft Skills

Strong Organizational SkillsAttention To DetailAbility To Work IndependentlyTeam CollaborationPrioritization

Tools & Technologies

Billing SoftwarePayer PortalsMicrosoft Office SuiteKIPU EHR/EMRAll-In-One Practice Management Software

Industry Keywords

HealthcareBehavioral HealthHMO/PPOMedicareMedicaidUtilization ReviewHIPAA ComplianceNorthpoint Billing RequirementsDenial ManagementConfidentiality Standards

About the role

Key responsibilities & impact

Perform collections to ensure receipt of medical claims within twenty-eight (28) days
Make outbound telephone calls to insurance companies and utilize payer portals for claims resolution
Coordinate with insurance companies to ensure timely payment for services rendered
Follow billing and collection protocols to ensure accurate and timely reimbursement
Review accounts receivable accounts and identify payer issues affecting payment delays
Contact payers to understand denials and changes needed to receive payment
Prepare appeals when claim denials are payer errors
Document all correspondence with payers in the billing system
Collaborate with Utilization Review for prior authorization and medical necessity documentation
Maintain accurate patient billing and payment records
Provide management reports on outstanding balances and collections activity
Collaborate with the RCM team and other departments
Maintain working knowledge of Northpoint billing and reimbursement requirements by payer
Adhere to company policies, procedures, confidentiality requirements, and HIPAA guidelines
Perform other job-related duties as assigned

Requirements

What you’ll need

2+ years of collections, billing reimbursement, payer relations, or medical Accounts Receivable required
Experience in a healthcare or behavioral health system with multiple levels of care preferred
Experience working with commercial medical insurance billing, as well as Medicaid, claims submission, and the technical aspects of billing software
All-in-one practice management, clearing house and billing software required
Proficient in navigating through payer portals
Must be proficient in CPT, HCPCS, and ICD-10 Codes, DSMS and ASAM criteria, data entry for various third party billing and payers, and their reimbursement and denial patterns
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems required
KIPU or similar EHR/EMR experience preferred
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
Familiarity with major payer guidelines
Proficiency with Microsoft Office Suite
Strong organizational skills, multitasking, prioritization, attention to detail, accuracy, and ability to work independently and within a team environment
Ability to maintain confidentiality in accordance with established policies, procedures, HIPAA, and standards of care

Benefits

Comp & perks

Subsidized Health Insurance Coverage for Employee, Spouse, & Dependent(s)
100% Employer Paid Basic Life Insurance equal to 1x annual salary, up to $100,000
100% Employer Paid Employee Assistance Program
Voluntary Dental, Vision, Short-Term Disability, Supplemental Life & AD&D, Critical Illness, Accident, and Hospital Indemnity Insurance.
Pre-tax Savings Accounts for all IRS-allowable medical and dependent care expenses
Generous Paid Time Off plan
Employee Referral Bonuses
401K Retirement Plan & Employer Match