Teams at The Auctus Group

Supports healthcare revenue cycle and Independent Dispute Resolution activities by reviewing claims, EOBs, ERAs, denials, underpayments, and payer correspondence. Follows up on outstanding accounts, identifies potential IDR cases, organizes documentation, tracks deadlines, reconciles payments, and maintains accurate records. Reviews coding, modifiers, CPT/NCCI issues, and reimbursement requirements while coordinating with internal teams and payers. Requires medical billing or related revenue cycle experience and strong knowledge of healthcare claims and payer processes.

Manage strategy and lifecycle for out-of-network claims and Independent Dispute Resolution (IDR): assess eligibility, prepare persuasive submissions, track deadlines, negotiate settlements, oversee financial recovery and reconciliation, ensure procedural compliance, coach team members, and serve as primary client contact to maximize lawful reimbursements.