Billing Coordinator - IDR

About The Auctus Group LLC Who we are: We’re big on people and culture at the Auctus Group. Our most important role as a company is to provide an amazing working environment for our team. We’ve been work-from-home-warriors since before it was cool. We support (like encourage and fund) continuing education. We match charitable donations. Our whole goal is: work to live not live to work. Oh and we’re weirdos too…we do remote happy hours and have a book club and goofy stuff like that. Who we’re looking for: Smart, talented, tech-savvy, experienced, go-getter types. You’ll do well if: - you like a fast-paced environment, - you thrive with change and development, - you like giving feedback, - you’re a team player, - you love learning/sleuthing, - you’re big on accountability. 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 preferred but not required. Candidates with strong medical billing, accounts receivable, denial management, or payer follow-up experience who are willing to learn 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 - 2+ years of medical billing, accounts receivable, denial management, or related Revenue Cycle Management experience. - Strong understanding of healthcare claims, EOBs, ERAs, denials, underpayments, and payer follow-up. - Knowledge of CPT, ICD-10, modifiers, and payer guidelines. - Familiarity with professional and/or surgical billing. - Strong attention to detail and ability to work with large volumes of claims and documentation. - Strong organizational and time-management skills. - Ability to track multiple deadlines and follow-up activities accurately. - Strong written and verbal communication skills. - Comfortable communicating with payers and internal team members. - Experience using EHRs, practice management systems, clearinghouses, and payer portals. - Ability to learn new systems, payer requirements, and IDR workflows. - Candidates must have a reliable computer and high-speed internet to perform job duties efficiently in a remote work environment. Preferred Qualifications - Experience with Independent Dispute Resolution (IDR), the No Surprises Act, or open negotiation processes. - Experience with out-of-network claims and reimbursement disputes. - Experience reviewing underpayments and negotiating or appealing payer reimbursement. - Surgical billing experience. - Familiarity with claim appeals and supporting documentation. - Plastic Surgery and/or Dermatology billing experience is a plus. Originally posted on Himalayas