Company Overview
Tal Healthcare has been a trusted leader in healthcare recruitment and executive search since 2006. Specializing in placing top talent—including physicians, nurse leaders, physician assistants, and professionals in finance, IT, revenue, and operations—they help healthcare organizations build strong, high-performing teams. With deep industry expertise and a personalized approach, Tal Healthcare ensures the perfect fit between candidates and employers, driving long-term success. Serving hospitals, medical practices, and academic medical centers, they have been shaping the healthcare workforce for nearly two decades.
Learn more at www.talhealthcare.com.
Medical Billing and Follow-Up Specialist
Our client, a national healthcare services company, is seeking a Medical Billing and Follow-Up Specialist to support medical operations across the country, including New York.
Responsibilities:
- Manage bill submissions, appeals, and grievances, both electronically and manually.
- Research and resolve denied insurance claims, ensuring timely resubmission.
- Develop strategies to overturn claim denials and maintain compliance with regulatory guidelines.
- Prepare appeal documentation, summaries, and correspondence while tracking key metrics.
- Analyze insurance policies to determine medical necessity criteria.
- Request and review medical records, notes, and detailed bills as needed.
- Collaborate with team members to optimize appeal strategies.
- Stay updated on billing regulations and track appeal outcomes.
- Ensure compliance with state, federal, and company guidelines.
- Hybrid role with 2–3 days in-office.
Requirements:
- Experience in hospital billing, insurance appeals, and regulatory compliance.
- Strong understanding of Commercial Insurance, Medicare, Medicaid, NCCI guidelines, and LCD/NCD edits.
- Knowledge of Tri-State Area payers and fiscal intermediaries.
- Proficiency in MS Office and familiarity with insurance claim processes.
- Excellent organizational, communication, and analytical skills.
- Ability to prioritize tasks, meet deadlines, and comply with HIPAA regulations.
Salary: Based on experience, qualifications, and education. Contact us for details.