Medical Billing & Denials Specialist

Job Title: Medical Billing & Denials Specialist Location: Remote (Global) Compensation: 1500 – 2000 USD/month Work Schedule: Monday-Friday, 9:00 AM to 5:00 PM (EST) NOTE: INDEPENDENT CONTRACTOR POSITION About the Company: Sagan represents a rapidly growing behavioral healthcare provider based in New Jersey. The organization serves patients ages five and older through both in-person and telehealth services, offering psychiatry, therapy, medication management, and autism evaluations (ADOS). As a fast-scaling healthcare organization, the team is committed to operational excellence, regulatory compliance, and delivering outstanding patient care through efficient revenue cycle management. Position Overview: The Medical Billing & Denials Specialist is responsible for submitting clean claims, reducing denials, and maximizing reimbursement through effective denial management, appeals, and accounts receivable follow-up. This role partners closely with clinical staff to resolve coding, documentation, and authorization issues while ensuring compliance with payer guidelines. We’re looking for a detail-oriented revenue cycle professional with strong U.S. medical billing experience who takes ownership of their work, enjoys solving complex billing issues, and thrives in a fast-paced healthcare environment. Key Responsibilities: • Review and scrub medical claims for CPT, HCPCS, ICD-10 coding, and modifier accuracy before submission. • Investigate denied claims, identify root causes, and submit corrected claims or appeals within payer filing deadlines. • Manage denial and appeals workflows from start to finish across commercial insurance, Medicare, and Medicaid payers. • Follow up on aging accounts receivable and take appropriate action to maximize reimbursement. • Collaborate with providers and clinical staff to resolve coding, documentation, authorization, and billing issues affecting claim payment. • Ensure compliance with CMS, New Jersey Medicaid, and commercial payer billing requirements. • Accurately document claim activity, payer communications, and appeal outcomes within billing systems. • Monitor denial trends and recommend process improvements to reduce future claim issues. • Maintain HIPAA compliance and protect patient health information (PHI). Qualifications: • 3+ years of experience in U.S. medical billing, revenue cycle, or denial management. • Strong working knowledge of CPT, HCPCS, and ICD-10 coding. • Experience reviewing and applying appropriate billing modifiers to ensure accurate claim submission and payer compliance. • Demonstrated experience managing denials, appeals, and accounts receivable follow-up. • Familiarity with CMS, Medicaid, and commercial payer billing requirements; experience with New Jersey Medicaid is a plus. • Strong analytical skills with the ability to identify the root cause of claim denials. • Excellent attention to detail and organizational skills. • Strong written and verbal English communication skills. • Ability to manage multiple priorities while meeting payer deadlines. • Comfortable working independently in a remote environment. Nice-to-Haves: • CPC (Certified Professional Coder) or equivalent certification. • Experience in behavioral health or psychiatry billing. • Experience working with EMR/EHR and revenue cycle management software. • Familiarity with prior authorizations and medical necessity requirements. • Intermediate to advanced Excel skills. Resume Submission Guidelines: ★ To help us review your application efficiently, please submit your resume in text-based PDF format only. ★ Avoid uploading scanned documents, image files (JPG/PNG), or Word documents (DOC/DOCX) format to prevent your application from being overlooked. ★ Important: For timely processing, both your resume and introductory video must be submitted in English.