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