You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Title: Physician Claims Representative – AR/Denials Specialist
Location: Remote (Must have reliable high-speed internet and a plugged-in modem)
Job Type: Full-Time

About the Role:
We are seeking a detail-oriented and experienced Accounts Receivable Representative to join our revenue cycle team. This individual will focus on physician billing for a specialty practice and an Ambulatory Surgery Center (ASC), ensuring timely and accurate claim resolution. The ideal candidate is experienced in working daily denials, navigating multiple payers, and resolving accounts receivable efficiently while maintaining high-quality standards.

Key Responsibilities:

• Manage daily denials, identify reasons for denial, make corrections, and determine next steps for claim resolution.
• Handle light patient interaction via email and occasional phone calls regarding billing questions or disputes.
• Review accounts for customer balances and ensure proper follow-up.
• Work through insurance portals and maintain consistent payor correspondence.

• Address common denial types including:

  • Coordination of Benefits (COB) issues

  • Frequency denials (time-of-service denial types)

  • Medical necessity or medical records denials

  • Out-of-network denials

  • No authorization denials (including clarifications with insurance when authorization exists)

• Collaborate with coding teams to ensure documentation is adequate and compliant.
• Maintain daily AR and outstanding claims, taking appropriate actions for claims over 30 days.

• Communicate feedback on billing trends and issues to relevant parties, including physicians.

Accounts/Client Focus:

• Physician billing, including one ASC client
• Specialties include Nephrology, Rheumatology, Multi-specialty, Family Practice, Pulmonology, and Transplant (experience in any of these is a plus)

Payer Experience:

• All commercial payers
• ​​​​​​​Medicare and Medicaid

• Workers’ Compensation

Performance Metrics:

• Average daily claim resolution goal: 65 claims/day (with largest volumes 80+ claims/day)
• ​​​​​​​Focus on quality of claim resolution, not just re-filing claims

Qualifications & Requirements:

• High school diploma required
• ​​​​​​​2–3+ years of AR experience with true claim resolution
• Stable work history with legitimate reasons for any employment gaps
• ​​​​​​​Experience in physician billing; ASC environment a plus
• Proficiency with one or more billing systems: EPIC, ECW, Allscripts, Athena, NextGen (EPIC being a key requirement) 
• ​​​​​​​Blend of commercial and government payer experience (Medicare, Medicaid) preferred
• Strong understanding of coordination of benefits and denial types
• ​​​​​​​Ability to handle daily denials within 24 hours and manage claims >30 days

• Comfortable working independently with initiative to address trends and provide feedback

Nice to Have:

• Experience across multiple specialties, particularly Nephrology, Rheumatology, or Transplant providers
• ​​​​​​​Experience working for a specialty group over general family practice

What We Offer:

• Competitive salary

• Remote flexibility with reliable support

• Opportunity to work with a dynamic, collaborative revenue cycle team

• Exposure to multiple specialties and payers for professional growth

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.