Billing Coordinator - IDR
The Auctus Group · 28 days ago
About The Role
The Billing Coordinator - IDR supports Revenue Cycle Management and Independent Dispute Resolution activities for out-of-network and underpaid healthcare claims.
This role combines strong medical billing fundamentals with detailed claim review, payer follow-up, documentation, and administrative support throughout the IDR process.
Prior IDR experience is required. Candidates with strong medical billing, accounts receivable, denial management, or payer follow-up experience who are willing to learn more of the IDR processes are encouraged to apply.
What You'll Do
- Review claims, EOBs, ERAs, remittance information, payer correspondence, and account documentation.
- Follow up on unpaid, underpaid, and denied claims.
- Identify claims that may require additional review for open negotiation or IDR.
- Assist with gathering and organizing documentation needed for IDR cases.
- Track important case dates, payer responses, filing deadlines, and follow-up requirements.
- Support open negotiation and IDR workflows according to established procedures.
- Maintain accurate documentation of claim activity, communications, submissions, and outcomes.
- Work accounts receivable across aging buckets with a focus on timely reimbursement and resolution.
- Review payment discrepancies and assist with payment reconciliation.
- Coordinate with IDR Managers, Revenue Cycle Managers, Billers, and other team members to resolve claim issues.
- Escalate complex, high-risk, or unusual cases to the appropriate team member.
- Follow established payer guidelines, internal workflows, and documentation requirements.
- Maintain complete, accurate, and organized case and billing records.
- Analyze billed services to ensure claims meet coding, compliance, and reimbursement requirements.
- Apply and review modifiers, identify CPT/NCCI issues, understand reimbursement impacts, and recommend claim corrections when appropriate.
- Adhere strictly to HIPAA and patient confidentiality requirements.
- Perform additional duties as assigned to support Revenue Cycle and IDR operations.
Qualifications
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2+ years of medical billing, accounts receivable, denial management, or related Revenue Cycle Management experience.
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Strong understanding of healthcare claims, EOBs, ERAs, denials, underpayments, and payer follow-up.
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Knowledge of CPT, ICD-10, modifiers, and payer guidelines.
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Familiarity with professional and/or surgical billing.
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Strong attention to detail and ability to work with large volumes of claims and documentation.
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Strong organizational and time-management skills.
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Ability to track multiple deadlines and follow-up activities accurately.
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Strong written and verbal communication skills.
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Comfortable communicating with payers and internal team members.
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Experience using EHRs, practice management systems, clearinghouses, and payer portals.
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Ability to learn new systems, payer requirements, and IDR workflows.
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Candidates must have a reliable computer and high-speed internet to perform job duties efficiently in a remote work environment.
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Experience with Independent Dispute Resolution (IDR), the No Surprises Act, or open negotiation processes.
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Experience with out-of-network claims and reimbursement disputes.
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Experience reviewing underpayments and negotiating or appealing payer reimbursement.
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Surgical billing experience.
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Familiarity with claim appeals and supporting documentation.
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Plastic Surgery and/or Dermatology billing experience is a plus.
