About The Auctus Group LLC
Who we are: We’re big on people and culture at the Auctus Group. Our most important role as a company is to provide an amazing working environment for our team. We’ve been work-from-home-warriors since before it was cool. We support (like encourage and fund) continuing education. We match charitable donations. Our whole goal is: work to live not live to work. Oh and we’re weirdos too…we do remote happy hours and have a book club and goofy stuff like that.
Who we’re looking for: Smart, talented, tech-savvy, experienced, go-getter types. You’ll do well if:
- you like a fast-paced environment,
- you thrive with change and development,
- you like giving feedback,
- you’re a team player,
- you love learning/sleuthing,
- you’re big on accountability.
The Billing Coordinator - IDR supports Revenue Cycle Management and Independent Dispute Resolution activities for out-of-network and underpaid healthcare claims.
This role combines strong medical billing fundamentals with detailed claim review, payer follow-up, documentation, and administrative support throughout the IDR process.
Prior IDR experience is required. Candidates with strong medical billing, accounts receivable, denial management, or payer follow-up experience who are willing to learn more of the IDR processes are encouraged to apply.
What You'll Do- Review claims, EOBs, ERAs, remittance information, payer correspondence, and account documentation.
- Follow up on unpaid, underpaid, and denied claims.
- Identify claims that may require additional review for open negotiation or IDR.
- Assist with gathering and organizing documentation needed for IDR cases.
- Track important case dates, payer responses, filing deadlines, and follow-up requirements.
- Support open negotiation and IDR workflows according to established procedures.
- Maintain accurate documentation of claim activity, communications, submissions, and outcomes.
- Work accounts receivable across aging buckets with a focus on timely reimbursement and resolution.
- Review payment discrepancies and assist with payment reconciliation.
- Coordinate with IDR Managers, Revenue Cycle Managers, Billers, and other team members to resolve claim issues.
- Escalate complex, high-risk, or unusual cases to the appropriate team member.
- Follow established payer guidelines, internal workflows, and documentation requirements.
- Maintain complete, accurate, and organized case and billing records.
- Analyze billed services to ensure claims meet coding, compliance, and reimbursement requirements.
- Apply and review modifiers, identify CPT/NCCI issues, understand reimbursement impacts, and recommend claim corrections when appropriate.
- Adhere strictly to HIPAA and patient confidentiality requirements.
- Perform additional duties as assigned to support Revenue Cycle and IDR operations.
- 2+ years of medical billing, accounts receivable, denial management, or related Revenue Cycle Management experience.
- Strong understanding of healthcare claims, EOBs, ERAs, denials, underpayments, and payer follow-up.
- Knowledge of CPT, ICD-10, modifiers, and payer guidelines.
- Familiarity with professional and/or surgical billing.
- Strong attention to detail and ability to work with large volumes of claims and documentation.
- Strong organizational and time-management skills.
- Ability to track multiple deadlines and follow-up activities accurately.
- Strong written and verbal communication skills.
- Comfortable communicating with payers and internal team members.
- Experience using EHRs, practice management systems, clearinghouses, and payer portals.
- Ability to learn new systems, payer requirements, and IDR workflows.
- Candidates must have a reliable computer and high-speed internet to perform job duties efficiently in a remote work environment.
- Experience with Independent Dispute Resolution (IDR), the No Surprises Act, or open negotiation processes.
- Experience with out-of-network claims and reimbursement disputes.
- Experience reviewing underpayments and negotiating or appealing payer reimbursement.
- Surgical billing experience.
- Familiarity with claim appeals and supporting documentation.
- Plastic Surgery and/or Dermatology billing experience is a plus.
Skills Required
- 2+ years of medical billing, accounts receivable, denial management, or related revenue cycle management experience
- Strong understanding of healthcare claims, EOBs, ERAs, denials, underpayments, and payer follow-up
- Knowledge of CPT, ICD-10, modifiers, and payer guidelines
- Familiarity with professional and/or surgical billing
- Strong attention to detail and ability to manage large volumes of claims and documentation
- Strong organizational and time-management skills
- Ability to accurately track multiple deadlines and follow-up activities
- Strong written and verbal communication skills
- Comfort communicating with payers and internal team members
- Experience using EHRs, practice management systems, clearinghouses, and payer portals
- Ability to learn new systems, payer requirements, and IDR workflows
- Reliable computer and high-speed internet for remote work
- Experience with Independent Dispute Resolution, the No Surprises Act, or open negotiation processes
- Experience with out-of-network claims and reimbursement disputes
- Experience reviewing underpayments and negotiating or appealing payer reimbursement
- Surgical billing experience
- Familiarity with claim appeals and supporting documentation
- Plastic Surgery and/or Dermatology billing experience
What We Do
We are an operations and consulting firm for plastic surgeons and dermatologists. We offer a number of service lines guided at letting our surgeons/doctors do what they love, while we handle the business end. We are building towards an all-in-on platform offering physicians a single solution to view their entire financial and operational snapshot
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