Billing & Insurance Claims Specialist (Healthcare)
N8TiVe Consulting, New Orleans, LA, United States
We’re seeking an experienced
Billing & Insurance Claims Specialist
to take ownership of end-to-end healthcare claims operations for a growing practice. This role is ideal for someone who thrives in complex payer environments, understands payer portals and escalation paths, and has a demonstrated history of
recovering significant revenue
through disciplined follow-up, appeals, and dispute resolution.
This is not a data-entry role. We’re looking for a specialist who knows how to navigate payer behavior, portals, and processes to efficiently recover claims for
small businesses .
What You’ll Do
Manage the
full claims lifecycle : submission, follow-up, denial management, appeals, and payment posting
Operate confidently in
Tebra ,
Availity , and comparable practice management and payer portal systems
Identify, investigate, and resolve
denied, delayed, or underpaid claims
across multiple payers
Prepare and submit
first-level and advanced appeals , including administrative and clinical narratives
Escalate claims to
payer leadership, legal counsel, or independent review organizations (IRP / IRO)
when appropriate
Track claim aging, identify systemic payer or workflow issues, and recommend improvements to increase collections velocity
Maintain clean, defensible documentation to support audits, appeals, and dispute resolution
What We’re Looking For
5+ years
of healthcare billing and insurance claims experience
Proven track record of:
Recovering
$100K+ in unpaid or denied claims , or
Successfully processing
$1M+ in cumulative claims volume
Strong working knowledge of:
Tebra
(required)
Availity
and other payer portals
Claims workflows, EOBs/ERAs, denial reason codes, and payer-specific policies
Hands‑on experience with:
Appeals and dispute resolution
Independent Review Process (IRP / IRO)
Legal or pre‑legal escalation pathways
Highly organized, persistent, and comfortable working autonomously
Nice to Have
Experience supporting
small or growing healthcare practices
Familiarity with ACA and employer-sponsored plans
Experience coordinating with attorneys, compliance teams, or external reviewers
Why This Role
High-impact work with measurable financial outcomes
Autonomy and trust—results matter more than hours
Opportunity to stabilize and scale claims operations long-term
#J-18808-Ljbffr
Billing & Insurance Claims Specialist
to take ownership of end-to-end healthcare claims operations for a growing practice. This role is ideal for someone who thrives in complex payer environments, understands payer portals and escalation paths, and has a demonstrated history of
recovering significant revenue
through disciplined follow-up, appeals, and dispute resolution.
This is not a data-entry role. We’re looking for a specialist who knows how to navigate payer behavior, portals, and processes to efficiently recover claims for
small businesses .
What You’ll Do
Manage the
full claims lifecycle : submission, follow-up, denial management, appeals, and payment posting
Operate confidently in
Tebra ,
Availity , and comparable practice management and payer portal systems
Identify, investigate, and resolve
denied, delayed, or underpaid claims
across multiple payers
Prepare and submit
first-level and advanced appeals , including administrative and clinical narratives
Escalate claims to
payer leadership, legal counsel, or independent review organizations (IRP / IRO)
when appropriate
Track claim aging, identify systemic payer or workflow issues, and recommend improvements to increase collections velocity
Maintain clean, defensible documentation to support audits, appeals, and dispute resolution
What We’re Looking For
5+ years
of healthcare billing and insurance claims experience
Proven track record of:
Recovering
$100K+ in unpaid or denied claims , or
Successfully processing
$1M+ in cumulative claims volume
Strong working knowledge of:
Tebra
(required)
Availity
and other payer portals
Claims workflows, EOBs/ERAs, denial reason codes, and payer-specific policies
Hands‑on experience with:
Appeals and dispute resolution
Independent Review Process (IRP / IRO)
Legal or pre‑legal escalation pathways
Highly organized, persistent, and comfortable working autonomously
Nice to Have
Experience supporting
small or growing healthcare practices
Familiarity with ACA and employer-sponsored plans
Experience coordinating with attorneys, compliance teams, or external reviewers
Why This Role
High-impact work with measurable financial outcomes
Autonomy and trust—results matter more than hours
Opportunity to stabilize and scale claims operations long-term
#J-18808-Ljbffr