Billing Resolution Specialist - 100% Remote in Pacific Time Zone

We’re a fast-growing, fully remote healthcare organization on a mission to improve access to care—and we know our people make that possible. As we expand, we are adding a new role to our leadership team. We are seeking a Medical Billing Resolution Specialist who will be responsible for end-to-end claim resolution to ensure timely, accurate reimbursement and a clear, professional client billing experience.

** NOTE: Must be able to work Pacific Time Zone/PST Hours of 8am-5pm PST **

About Expressable

Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services, serving thousands of clients since our inception in late 2019. We are passionate advocates of parent-focused intervention. Our e-learning platform contains thousands of home-based learning modules authored by our clinical team, helping SLPs empower caregivers to integrate speech therapy techniques into their child’s daily life and improve outcomes. Our mission is to set a new standard in speech therapy by making every caregiver a champion of their loved one’s success. We envision a world where everyone can fulfill their communication potential.

The Medical Billing Resolution Specialist owns end-to-end claim resolution to ensure timely, accurate reimbursement and a clear, professional client billing experience. This role resolves denied, rejected, and held claims; supports medical necessity and authorization reviews; partners cross-functionally to prevent recurring issues; supports client invoicing during accounts receivable review; and engages directly with clients on escalated billing questions or concerns.

WORK AUTHORIZATION: We are interested in every qualified candidate who is eligible to work in the United States. However, we are not able to sponsor visas at this time.

What You Would Be Doing at Expressable

• Own the end-to-end resolution of rejected, denied, and held claims, including medical necessity, eligibility, authorization, and coding-related issues, through final payment or closure.

• Research, correct, refile, and appeal denied claims, ensuring appropriate clinical documentation and medical necessity support.

• Perform medical necessity reviews for continued services, partnering with clinical teams to validate documentation and payer criteria.

• Research payer medical policies, coverage determinations, and contract terms; communicate with insurance plans as needed.

• Maintain accountability for assigned claim inventories, including documentation, tracking, and system updates in billing platforms, EHR, and CRM tools.

• Identify denial trends and root causes and recommend process or documentation improvements to prevent future issues.

• Manage invoicing, accounts receivable, client payments, and balance reconciliation, including applicable discounts.

• Serve as a client-facing resource for billing and insurance inquiries, resolving issues related to benefits, claim status, invoices, and payments.

• Collaborate with internal teams and external revenue cycle partners to support coordinated claim research and appeals.

• Escalate complex or high-risk issues appropriately while ensuring compliance with HIPAA, payer, and company requirements.
  

• High school diploma or equivalent required.

• Associate degree or coursework in healthcare administration, medical billing, health information management, or a related field preferred.

• 2–4 years of experience in medical billing, revenue cycle, or claims resolution in a healthcare setting.

• Demonstrated experience resolving denied, rejected, or held claims, including eligibility, authorization, coding, and medical necessity denials.

• Experience reviewing payer medical policies and working directly with insurance plans on claim status, appeals, and reimbursement issues.

• Prior responsibility for accounts receivable follow-up, invoicing, and patient/client billing support.

• Experience collaborating with clinical or utilization management teams preferred.

• Working knowledge of medical billing and reimbursement processes, including claim submission, denial management, and appeals.

• Proficiency with ICD-10 coding validation and basic understanding of medical necessity requirements.

• Experience using electronic health records (EHR), billing systems, and CRM or ticketing tools.

• Strong documentation and data entry skills with attention to accuracy and audit readiness.

• Proficiency with Microsoft Excel and/or Google Sheets for tracking, reconciliation, and reporting.
  

• Exceptional paid time off policies that encourage and support life balance, including a winter break.

• 401k matching to ensure our staff have what they need to enjoy their retirement

• Health insurance options that ensure well being for the whole person and their family

• Company paid life, short-term disability, and long-term disability coverage

• Remote work environment that strives for connectivity through professional collaboration and personal connections

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.