Senior Billing Specialist
Doctor Keloid Scar and Cosmetic Center, New York, New York, us, 10261
Title - Senior manager of Insurance Claims & Appeals (In-House)
Location -
New York City (In-Person)
Role -
Full-Time - On- site
About Us Doctor Keloid – Scar & Cosmetic Center is a specialized healthcare practice focused on advanced scar, keloid, and cosmetic treatments. We are committed to delivering high-quality patient care with high-level of patient satisfaction.
About the Role We are seeking an experienced
insurance expert
to lead our
in-house insurance claims and appeals operations . This role is ideal for someone who deeply understands how insurance companies work and has hands‑on experience
challenging denials, underpayments, and delayed claims , especially in
out-of-network scenarios .
This is a
strategic and hands‑on leadership role , where you will be responsible for fighting claims, building processes, and driving reimbursement outcomes.
Key Responsibilities
Lead and oversee all insurance claims and appeals processes
Handle complex and high‑value appeals, including medical necessity and reimbursement disputes
Develop and execute strategies to maximize
out-of-network reimbursement
Analyze payer policies, EOBs, and denial trends to improve collections
Act as the in‑house expert on insurance tactics, payer behavior, and reimbursement rules
Work closely with leadership, clinical staff, and operations to support revenue integrity
Create and improve workflows, documentation, and appeal templates
Train and guide internal staff on best practices for claims and appeals
Required Qualifications
7+ years of experience in healthcare insurance billing, claims, and appeals
Strong expertise in
out-of-network insurance billing
Experience with Python or C++
(for data analysis, automation, or systems support)
Proven track record of successfully overturning denials and recovering revenue
Deep understanding of commercial insurance plans and payer processes
Excellent written and verbal communication skills (appeals writing is critical)
Highly organized, persistent, and detail-oriented
Must be able to work
on‑site in NYC
Preferred Qualifications
Prior leadership or director-level experience
Experience with Tableau & R
Experience in specialty healthcare, cosmetic, dermatology, or surgical practices
Familiarity with regulatory and compliance considerations in insurance disputes
Experience building or managing an in‑house insurance department
Why Join Doctor Keloid
In‑house, decision‑making role with real impact
Opportunity to lead and shape insurance strategy
Work closely with a specialized, growing healthcare practice
Competitive compensation based on experience
#J-18808-Ljbffr
New York City (In-Person)
Role -
Full-Time - On- site
About Us Doctor Keloid – Scar & Cosmetic Center is a specialized healthcare practice focused on advanced scar, keloid, and cosmetic treatments. We are committed to delivering high-quality patient care with high-level of patient satisfaction.
About the Role We are seeking an experienced
insurance expert
to lead our
in-house insurance claims and appeals operations . This role is ideal for someone who deeply understands how insurance companies work and has hands‑on experience
challenging denials, underpayments, and delayed claims , especially in
out-of-network scenarios .
This is a
strategic and hands‑on leadership role , where you will be responsible for fighting claims, building processes, and driving reimbursement outcomes.
Key Responsibilities
Lead and oversee all insurance claims and appeals processes
Handle complex and high‑value appeals, including medical necessity and reimbursement disputes
Develop and execute strategies to maximize
out-of-network reimbursement
Analyze payer policies, EOBs, and denial trends to improve collections
Act as the in‑house expert on insurance tactics, payer behavior, and reimbursement rules
Work closely with leadership, clinical staff, and operations to support revenue integrity
Create and improve workflows, documentation, and appeal templates
Train and guide internal staff on best practices for claims and appeals
Required Qualifications
7+ years of experience in healthcare insurance billing, claims, and appeals
Strong expertise in
out-of-network insurance billing
Experience with Python or C++
(for data analysis, automation, or systems support)
Proven track record of successfully overturning denials and recovering revenue
Deep understanding of commercial insurance plans and payer processes
Excellent written and verbal communication skills (appeals writing is critical)
Highly organized, persistent, and detail-oriented
Must be able to work
on‑site in NYC
Preferred Qualifications
Prior leadership or director-level experience
Experience with Tableau & R
Experience in specialty healthcare, cosmetic, dermatology, or surgical practices
Familiarity with regulatory and compliance considerations in insurance disputes
Experience building or managing an in‑house insurance department
Why Join Doctor Keloid
In‑house, decision‑making role with real impact
Opportunity to lead and shape insurance strategy
Work closely with a specialized, growing healthcare practice
Competitive compensation based on experience
#J-18808-Ljbffr