The Medical Billing Specialist is responsible for managing healthcare insurance appeals and supporting revenue recovery initiatives by working with insurance payers to secure appropriate reimbursement for patient services. This role analyzes payer rejections and denial trends, prepares successful appeal submissions, and collaborates with internal teams to improve revenue cycle processes.

- Review and manage denied or rejected healthcare claims requiring appeal submission.
- Prepare and submit high-volume insurance appeals to payers to obtain reimbursement.
- Research denial reasons, payer requirements, and supporting documentation needed for successful resolution.
- Monitor appeal outcomes and identify opportunities to improve payment recovery.
- Analyze payer rejection and denial trends to identify recurring issues and process gaps.
- Review accounts receivable activities related to denied or unpaid claims.
- Apply knowledge of healthcare billing processes, ICD-10 coding, and payer guidelines when resolving claim issues.
- Provide feedback and recommendations to improve revenue cycle performance.
- Communicate with insurance carriers through phone and other channels regarding appeals and reimbursement issues.




- Collaborate with billing, operations, and other internal teams to resolve claim-related challenges.
- Support the development of best practices to improve payer interactions and workflow efficiency.
- Maintain accurate documentation of appeal activities, payer responses, and claim resolution status.
- Track trends and provide insights related to denials, reimbursement barriers, and payer performance.
- Participate in process improvement initiatives supporting healthcare operations.
- Experience handling insurance payer communications and follow-ups.
- Knowledge of ICD-10, account receivable workflows, and healthcare reimbursement processes.
- Demonstrates strong understanding of healthcare insurance appeals processes and denial resolution.
- Demonstrates strong attention to detail and organizational skills.
- Proven ability to manage high-volume workloads while maintaining accuracy.
- Self-motivated, adaptable, and able to work effectively in a fast-paced environment.
- Clear and coherent both written and verbal communication skills in English.

📌 Medical Biller (Bogotá)
🏢 Connext
📍 Bogotá