AdvancedMD · 1 day ago
Reimbursement Specialist II
AdvancedMD is a healthcare technology leader that provides a unified cloud suite of medical office software. They are seeking a detail-oriented Reimbursement Specialist II to manage the full lifecycle of medical claims, optimize reimbursement processes, and ensure client satisfaction through effective communication and problem-solving.
Cloud ComputingHealth CareSoftware
Responsibilities
Correct claims pre-submission for identified edits that will result in a claim denial or delay
Follow up on denied and rejected claims as identified through carrier denials/rejections via software or EOBs
Follow up on unpaid claims in an aged approach for final claim resolution
Communicate payer requirements or updates to clients and leadership
Proactively assist clients in identifying specific claim edits to avoid future claim denials
Communicate effectively and proactively with clients to avoid escalation
Track A/R progress and profitability of client accounts
Identify and analyze reimbursement trends within the client office key
Identify and communicate payer trends
Qualification
Required
3+ years of medical billing experience
Knowledge of Medicare, Medicaid and commercial payors claims and appeals processing requirements
Intermediate knowledge of ICD, CPT and HCPCS coding, ability to read EOB and ERA files
General understanding of CCI edits and carrier specific coding edits
Strong working knowledge of Windows, MS Word, Internet Explorer, Excel, and Outlook
Must have a good understanding of the Medical Billing Process and Industry Standards
Ability to manage and fulfill client expectations independently by managing client questions, processes and escalations
Excellent written and oral communication skills
Preferred
You're highly motivated and self-driven
You have a positive attitude (training, resiliency, appreciate the growth from adversity)
You are highly team oriented and focus on the success of your peers as well as yourself
Proven track record of writing compelling appeals with favorable outcomes
Excellent communication and organizational skills with a customer service focus
Ability to prioritize effectively and handle shifting priorities professionally
Knowledge of medical computerized billing and scheduling software systems
Ability to communicate with various business contacts in a professional and courteous manner
Self-starter with the ability to organize work for maximum efficiency and attention to quality
Proven ability to meet deadlines in a fast-paced environment
Ability to grasp new concepts and procedures quickly, with a desire to learn
Benefits
Comprehensive health, dental, and vision insurance
401(k) with generous company match
Paid time off and holidays
Hybrid and remote work opportunities
Career growth and development support
Collaborative, team-oriented culture
Company
AdvancedMD
AdvancedMD is a healthcare technology company that offers cloud medical office software to ambulatory medical practices.
Funding
Current Stage
Late StageTotal Funding
unknown2024-10-30Acquired
Leadership Team
Recent News
2025-12-16
2025-10-24
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