Global Technical Talent, an Inc. 5000 Company · 10 hours ago
Senior Billing & Insurance Advisor
United States
Full-time
Remote
Senior LevelGlobal Technical Talent, an Inc. 5000 Company, is seeking a Senior Billing & Insurance Advisor. The role involves expert medical billing advocacy, insurance claims resolution, and providing assistance with Medicare and private insurance analysis and enrollment. Responsibilities include resolving claims issues, preparing appeals, and guiding clients through their insurance options.
CRMHuman ResourcesInformation TechnologyStaffing Agency
Responsibilities
Resolve unpaid, underpaid, or incorrectly denied claims through investigation, follow-up, and escalation
Tracking and submitting out-of-network claims
Auditing medical bills, EOBs, and payment histories for accuracy
Identify billing errors, coding issues, or coverage mismatches that impact client balances and benefits
Reduce client out-of-pocket costs through reconsiderations, correction-claims, and coordination of benefits
Preparing and submitting appeals with supporting documentation and necessary authorizations
Following up on prior authorizations, referrals, and claim statuses
Keep cases moving forward with clear documentation, timelines, and accountability
Serve as a knowledgeable representative/mediator between patients, providers, and insurance carriers, and be able to communicate on the member's behalf professionally
Interpret plan documents, explain benefits clearly, and provide accurate, client-ready guidance that helps members make informed decisions and use their coverage effectively
Provide expert benefit interpretation for both Medicare and private insurance policies (coverage rules, exclusions, cost-sharing, prior auth, referrals, network rules, etc.)
Produce professional, high-quality insurance reports that translate complex plan information into clear, actionable recommendations
Guide members through complex scenarios (out-of-network care, referrals, prior authorizations, COB, appeals, and plan changes)
Identify the best path forward for each case by matching member goals + provider needs + plan limitations
Communicate clearly and confidently with members, providers, carriers, and internal stakeholders
Reviewing plan documents (Client/EOC), benefits, networks, and formularies
Verifying coverage rules and cost exposure, including deductible/MOOP tracking where relevant
Creating and updating insurance comparison reports (Medicare and private insurance)
Educating members and providing step-by-step guidance for using benefits or resolving barriers
Documenting interactions and recommendations in internal systems
Qualification
Required
Expert medical billing advocacy, insurance claims resolution, and Medicare/private insurance analysis, plan comparison, and enrollment assistance
Resolve unpaid, underpaid, or incorrectly denied claims through investigation, follow-up, and escalation
Tracking and submitting out-of-network claims
Auditing medical bills, EOBs, and payment histories for accuracy
Identify billing errors, coding issues, or coverage mismatches that impact client balances and benefits
Reduce client out-of-pocket costs through reconsiderations, correction-claims, and coordination of benefits
Preparing and submitting appeals with supporting documentation and necessary authorizations
Following up on prior authorizations, referrals, and claim statuses
Keep cases moving forward with clear documentation, timelines, and accountability
Serve as a knowledgeable representative/mediator between patients, providers, and insurance carriers, and be able to communicate on the member's behalf professionally
Interpret plan documents, explain benefits clearly, and provide accurate, client-ready guidance that helps members make informed decisions and use their coverage effectively
Provide expert benefit interpretation for both Medicare and private insurance policies (coverage rules, exclusions, cost-sharing, prior auth, referrals, network rules, etc.)
Produce professional, high-quality insurance reports that translate complex plan information into clear, actionable recommendations
Guide members through complex scenarios (out-of-network care, referrals, prior authorizations, COB, appeals, and plan changes)
Identify the best path forward for each case by matching member goals + provider needs + plan limitations
Communicate clearly and confidently with members, providers, carriers, and internal stakeholders
Reviewing plan documents (Client/EOC), benefits, networks, and formularies
Verifying coverage rules and cost exposure, including deductible/MOOP tracking where relevant
Creating and updating insurance comparison reports (Medicare and private insurance)
Educating members and providing step-by-step guidance for using benefits or resolving barriers
Documenting interactions and recommendations in internal systems
Microsoft Office (Excel, Word, Outlook) Experience To Complete The Following: Excel: track claims, payments, balances, timelines, and appeal status accurately
Word: draft clear appeal letters, billing correction requests, and case summaries
Outlook: manage high-volume follow-up communications and reminders
PDF/Document Reader/Editor Such as Adobe to complete the following: Review and reconcile bills, EOBs, and carrier correspondence
Organize documentation to support appeals and escalations
Edit and Complete Necessary Claim Forms and Provider Forms
Combine and annotate client files accordingly
Insurance Carrier Portals & Call Systems to complete the following: Check claim status, payment details, and authorization requirements
Navigate long or complex calls efficiently and document outcomes clearly
Escalate appropriately within carrier structures when needed
Coverage Confirmations, Assisting with Premium Payments
Insurance Plan Analysis and Enrollment Assistance
Microsoft Office (Excel, Word, Outlook) to build clean side-by-side comparisons (premium, deductible, MOOP, copays, coinsurance, out-of-network rules)
Word: create polished, client-ready reports and written recommendations
Outlook: manage member communication and follow-ups professionally
PDF / Document Management tools (Adobe or similar) to extract and organize key details from plan documents, bills/EOBs, and coverage letters
Combine, annotate, and support client files with proper documentation
Carrier / plan portals and search tools to use carrier portals and network search tools efficiently (provider/facility lookups, formulary checks, benefit summaries, prior auth rules)
Navigate Medicare tools as needed (Medicare.gov resources, SEP/ICEP rules references, plan tools)
CRM / Case documentation tools (Salesforce) to document coverage guidance, recommendations, and case status clearly
Track client cases from intake through resolution with accurate notes and follow-ups
Medical Billing & Claims Analysis: Understand how claims flow from provider → payer → patient
Spot common billing errors, denial patterns, and payment issues
Know when a claim needs correction vs. appeal vs. escalation
Persistence & Follow-Through: Diligence on long-running cases without letting them stall
Proactively follow up with carriers and providers until resolution
Keep pressure on timelines while remaining professional
Problem-Solving & Critical Thinking: Assess incomplete or conflicting information and determine next steps
Adjust strategy when claims or appeals are delayed or mishandled
Identify the most effective path to resolution for each situation
Clear, Professional Communication: Explain complex billing and insurance issues in plain language
Communicate confidently with providers, insurers, and clients
De-escalate tense billing situations while advocating firmly
Organization & Case Ownership: Manage multiple active claims simultaneously
Prioritize cases based on urgency and financial impact
Take ownership from intake through final resolution
Policy interpretation + insurance expertise: Understand and explain policy terms, limitations, exclusions, and authorization/referral rules
Accurately advise clients on what the plan will/won't cover and what steps are required
Analytical thinking + attention to detail: Catch details that impact member outcomes (network status, effective dates, prior auth triggers, coverage nuances)
Build comparisons that are accurate and defensible
Client communication + education: Translate insurance language into clear and calm guidance
Set expectations and reduce anxiety while remaining factual and compliant
Deliver recommendations that are easy for clients to follow
Ownership + organization: Manage multiple cases simultaneously without losing tasks
Follow through with a strong sense of accountability and timeliness
Professional advocacy / stakeholder navigation: Confidently engage carriers, providers, and third parties when needed
Escalate effectively and maintain professionalism throughout
Preferred
Medicare & Medicaid claims experience
Experience with Commercial Insurances including but not limited to: Anthem, Client, Client, Health Care Company, Healthcare (How to handle calls and submit claims to each)
Appeals experience (medical necessity, authorization, timely filing, coding)
Basic coding familiarity (CPT/HCPCS/ICD)
Medicare plan knowledge (supplements vs advantage, enrollment periods/SEPs, IRMAA awareness, etc.)
Experience with plan design and underwriting concepts (ACA vs off-exchange, EPO/PPO/HMO rules, COBRA transitions)
Basic medical billing awareness (EOB interpretation, common denial reasons)
Salesforce
Benefits
Medical, Vision, and Dental Insurance Plans
401k Retirement Fund
Company
Global Technical Talent, an Inc. 5000 Company
Global Technical Talent (GTT) is a leading provider of Total Talent Solutions and a proud subsidiary of Chenega Corporation(www.chenega.com), a Native American corporation with over $1.5 billion in revenue and 7,200 U.S.
Founded in 1999
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Mario Moussa
Director of Strategic Partnerships
Company data provided by crunchbase