Company Description
Abundant Health & Vitality Associates, PLLC is a physician-owned outpatient medical practice specializing in obesity medicine. We are seeking an experienced medical biller with demonstrated ERISA-based appeals success to manage insurance A/R follow-up and denials resolution.
This role is not entry-level and not a training position. The ideal candidate can independently work aged A/R, prepare ERISA-compliant appeals, and recover denied or underpaid claims.
U.S. work authorization required. W-2 part time employment only. No visa sponsorship.
Key Responsibilities:
• Work aged insurance A/R (commercial plans and Medicare)
• Investigate and resolve denied or underpaid claims
• Prepare, submit, and track ERISA-compliant appeals, including medical necessity appeals
• Follow up with payers through final resolution
• Identify payer denial trends and underpayment patterns (BCBS experience required)
• Maintain clear, audit-ready documentation of all actions taken
Initial Focus (First 30 Days)
• Insurance A/R and appeals ONLY
• No charge entry, coding, eligibility, or front-desk work
• Scope may expand based on performance
Position Details
• Schedule: Part-time, 20–25 hours/week
• Classification: W-2 employee
• Location: Remote (U.S.-based only)
• Work Hours: Must be performed during approved clinic hours (Eastern Time)
• Compensation: $20–$24/hour
• Benefits: Not included
• Growth: Opportunity to expand hours and scope based on results
Qualifications (REQUIRED)
• 3+ years of medical billing experience with direct insurance A/R responsibility
• Hands-on ERISA appeals experience (must be able to explain prior appeal wins)
• Strong background in insurance A/R and denials management
• Experience with commercial payers (BCBS, Aetna, and UHC required) and Medicare
• Ability to work independently with minimal oversight
• Strong attention to detail and documentation skills
• Ability to efficiently navigate an electronic health record (EHR) to retrieve clinical documentation for insurance appeals and audits
Certifications (REQUIRED)
• One active certification required:
– CPB (AAPC)
– CPC (AAPC)
– CBCS (NHA)
– CMRS (AMBA)
This role requires direct ERISA appeals experience. Applicants must have personally prepared and submitted ERISA appeals that resulted in payment. This position is not suitable for entry-level or junior billing roles, charge posting, payment posting, coding-only roles, or third-party billing companies, contractors, or agencies.
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