Billing Resolution Specialist - 100% Remote in Pacific Time Zone

<h2>Job Title: Medical Billing Resolution Specialist<br>Status: <strong>Full-Time Non-Exempt Direct Hire</strong><br>Location: <strong>Remote (must be able to work Pacific Time Zone/PST Hours 8am-5pm PST)<br>Target Pay Rate: $23.00-$26.00 per hour<br></strong></h2><p style="min-height:1.5em">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 <strong>Medical Billing Resolution Specialist </strong>who will be responsible for end-to-end claim resolution to ensure timely, accurate reimbursement and a clear, professional client billing experience.<br><br><em><strong>** NOTE: Must be able to work Pacific Time Zone/PST Hours of 8am-5pm PST **</strong></em><br><br><strong>About Expressable</strong></p><p style="min-height:1.5em">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.</p><p style="min-height:1.5em">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.<br><br><em><strong>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.</strong></em></p><p style="min-height:1.5em"><em><strong><br></strong></em><strong>What You Would Be Doing at Expressable</strong></p><ul style="min-height:1.5em"><li><p style="min-height:1.5em">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.</p></li><li><p style="min-height:1.5em">Research, correct, refile, and appeal denied claims, ensuring appropriate clinical documentation and medical necessity support.</p></li><li><p style="min-height:1.5em">Perform medical necessity reviews for continued services, partnering with clinical teams to validate documentation and payer criteria.</p></li><li><p style="min-height:1.5em">Research payer medical policies, coverage determinations, and contract terms; communicate with insurance plans as needed.</p></li><li><p style="min-height:1.5em">Maintain accountability for assigned claim inventories, including documentation, tracking, and system updates in billing platforms, EHR, and CRM tools.</p></li><li><p style="min-height:1.5em">Identify denial trends and root causes and recommend process or documentation improvements to prevent future issues.</p></li><li><p style="min-height:1.5em">Manage invoicing, accounts receivable, client payments, and balance reconciliation, including applicable discounts.</p></li><li><p style="min-height:1.5em">Serve as a client-facing resource for billing and insurance inquiries, resolving issues related to benefits, claim status, invoices, and payments.</p></li><li><p style="min-height:1.5em">Collaborate with internal teams and external revenue cycle partners to support coordinated claim research and appeals.</p></li><li><p style="min-height:1.5em">Escalate complex or high-risk issues appropriately while ensuring compliance with HIPAA, payer, and company requirements.<br></p></li></ul><p style="min-height:1.5em"><strong>What You Bring to Expressable</strong></p><ul style="min-height:1.5em"><li><p style="min-height:1.5em">High school diploma or equivalent required.</p></li><li><p style="min-height:1.5em">Associate degree or coursework in healthcare administration, medical billing, health information management, or a related field preferred.</p></li><li><p style="min-height:1.5em">2–4 years of experience in medical billing, revenue cycle, or claims resolution in a healthcare setting.</p></li><li><p style="min-height:1.5em">Demonstrated experience resolving denied, rejected, or held claims, including eligibility, authorization, coding, and medical necessity denials.</p></li><li><p style="min-height:1.5em">Experience reviewing payer medical policies and working directly with insurance plans on claim status, appeals, and reimbursement issues.</p></li><li><p style="min-height:1.5em">Prior responsibility for accounts receivable follow-up, invoicing, and patient/client billing support.</p></li><li><p style="min-height:1.5em">Experience collaborating with clinical or utilization management teams preferred.</p></li><li><p style="min-height:1.5em">Working knowledge of medical billing and reimbursement processes, including claim submission, denial management, and appeals.</p></li><li><p style="min-height:1.5em">Proficiency with ICD-10 coding validation and basic understanding of medical necessity requirements.</p></li><li><p style="min-height:1.5em">Experience using electronic health records (EHR), billing systems, and CRM or ticketing tools.</p></li><li><p style="min-height:1.5em">Strong documentation and data entry skills with attention to accuracy and audit readiness.</p></li><li><p style="min-height:1.5em">Proficiency with Microsoft Excel and/or Google Sheets for tracking, reconciliation, and reporting.<br></p></li></ul><p style="min-height:1.5em"><strong>KEY COMPETENCIES</strong><br>In addition to the competencies associated with our core values of empowerment, integrity, innovation, collaboration, and diversity, the Financial Clearance Coordinator should possess the following key competencies.</p><ul style="min-height:1.5em"><li><p style="min-height:1.5em"><strong>Claims Resolution & Follow-Through</strong> – Takes ownership of issues through final resolution, manages competing priorities, and ensures timely outcomes.</p></li><li><p style="min-height:1.5em"><strong>Medical Necessity & Payer Policy Acumen</strong> – Interprets payer policies, coverage criteria, and documentation requirements to support reimbursement and continued services.</p></li><li><p style="min-height:1.5em"><strong>Analytical Problem Solving</strong> – Investigates denials, identifies root causes, and applies structured thinking to resolve complex billing issues.</p></li><li><p style="min-height:1.5em"><strong>Attention to Detail & Compliance Orientation</strong> – Maintains high standards for accuracy, documentation, and adherence to HIPAA, payer, and internal requirements.</p></li><li><p style="min-height:1.5em"><strong>Client & Payer Communication</strong> – Communicates clearly and professionally with clients, payers, and internal stakeholders to resolve issues and set expectations.</p></li><li><p style="min-height:1.5em"><strong>Continuous Improvement Mindset</strong> – Identifies trends, recommends process improvements, and contributes to reducing future denials and rework.</p></li></ul><p style="min-height:1.5em"><strong><br>Physical Requirements and Work Environment<br></strong>This is a sedentary, remote position that primarily involves working at a computer or tablet for telecommunications and documentation. The role requires the ability to remain seated for extended periods, operate standard office equipment, communicate effectively via video and audio platforms, and review electronic information. Occasional light lifting of up to 10 pounds may be necessary. Work is performed in a home office environment with minimal exposure to environmental hazards.</p><p style="min-height:1.5em">Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.</p><p style="min-height:1.5em"><br><strong>Why Join Us?</strong></p><ul style="min-height:1.5em"><li><p style="min-height:1.5em">Exceptional paid time off policies that encourage and support life balance, including a winter break.</p></li><li><p style="min-height:1.5em">401k matching to ensure our staff have what they need to enjoy their retirement</p></li><li><p style="min-height:1.5em">Health insurance options that ensure well being for the whole person and their family</p></li><li><p style="min-height:1.5em">Company paid life, short-term disability, and long-term disability coverage</p></li><li><p style="min-height:1.5em">Remote work environment that strives for connectivity through professional collaboration and personal connections</p></li></ul><p style="min-height:1.5em"><strong><br>NOTE</strong></p><p style="min-height:1.5em">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.</p><p style="min-height:1.5em"><strong><br>More about Expressable<br></strong>Expressable values people. From the technology we develop, the services we provide, and the culture we maintain, Expressable cares about the experience of our employees, clients, and prospects. We intentionally create and sustain supportive environments in which everyone - clients, caregivers, speech-language pathologists, and team members - can achieve their highest potential.</p><p style="min-height:1.5em">We believe that building trusting and collaborative relationships is paramount to delivering quality care so we operate with the highest levels of honesty, transparency, and accountability as individuals and a collaborative team. We believe that transforming therapy happens through the steady and iterative problem solving of an interdisciplinary team.</p><p style="min-height:1.5em">Expressable is an equal opportunity workplace. We celebrate and embrace diversity and are committed to building a team that represents a broad tapestry of backgrounds, perspectives, and skills.</p><p style="min-height:1.5em">Expressable is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Expressable will take the steps to ensure people with disabilities are provided reasonable accommodations. Accordingly, if reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact us at hr@expressable.io.</p><p style="min-height:1.5em"><strong><br>E-Verify</strong></p><p style="min-height:1.5em">Federal law requires all employers to verify the identity and employment eligibility of all person hired to work in the United States. Expressable participates in E-Verify.</p><p style="min-height:1.5em"><a target="_blank" rel="noopener noreferrer nofollow" href="https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf"><u>E-Verify Participation Poster</u></a></p><p style="min-height:1.5em"><a target="_blank" rel="noopener noreferrer nofollow" href="https://www.everify.gov/sites/default/files/everify/posters/IER_RightToWorkPoster%20Eng_Es.pdf"><u>E-Verify Right to Work Poster</u></a></p>