Abundant Health & Vitality Associates, PLLC is seeking an experienced Insurance A/R & ERISA Appeals Specialist to support insurance revenue recovery through accounts receivable follow-up, denials management, and ERISA-based appeals for commercial payers and Medicare.
This role is not a coding position. It is focused on post-submission insurance revenue recovery. The ideal candidate can independently locate claims, documentation, and correspondence within an electronic health record and shared systems, and pursue claims through final resolution without requiring claims or documents to be sent to them.
This is not an entry-level role, not a training position, and not suitable for coding-only, charge posting–only, or third-party billing companies.
Application Process (Required)
This position uses a structured application process.
All applicants must apply via the secure application link provided and complete the required screening questions.
Applications that are incomplete, do not follow instructions, or do not demonstrate direct ERISA appeals experience will not be considered and may not receive a response.
Key Responsibilities & Expectations
• Work insurance A/R aged 60–365+ days
• Investigate denied and underpaid claims
• Prepare, submit, and track ERISA-compliant appeals, including medical necessity appeals
• Follow up with commercial payers and Medicare through final resolution
• Communicate professionally with insurance payers regarding claim status, denials, and appeals
• Independently locate claims, EOBs, and clinical documentation within the EHR
• Identify payer denial trends and underpayment patterns across commercial and government payers
• Maintain clear, accurate, and audit-ready documentation of all actions taken
• Access and manage appeal-related documents through assigned shared Drive folders
• Support additional billing-related tasks as needed to maintain revenue flow
Initial Focus (First 30 Days)
• Primary focus on insurance A/R follow-up and ERISA appeals
• Orientation to clinic systems, payer mix, and documentation standards
• Scope may flex based on clinic needs and demonstrated competence
Position Details
• Employment Type: W-2 employee
• Schedule: Part-time, up to 18 hours per week
• Location: Remote (U.S.-based only)
• Work Hours: Must be performed during approved clinic hours (Eastern Time)
• Compensation: Hourly, commensurate with experience and demonstrated results
• Benefits: Not included
• Growth: Opportunity to expand scope based on performance
Required Experience & Skills
• Minimum 2 years of hands-on medical billing experience with direct insurance A/R responsibility
• Demonstrated ERISA appeals experience (must have personally prepared and submitted ERISA appeals that resulted in payment)
• Required: Internal Medicine billing experience
• Preferred: Obesity medicine billing experience
• Strong background in insurance A/R and denials management
• Experience with BCBS, Aetna, UHC, Medicare, and other major commercial payers
• Proficiency navigating an electronic health record to locate claims and clinical documentation
• Comfort working within shared Drive-based systems for appeal documentation
• Strong written and verbal English communication skills sufficient for payer correspondence and formal insurance appeals
• Ability to work independently and reliably in a remote environment with secure internet access
• Strong documentation discipline, organization, and follow-through
Minimum Education Requirement
• High school diploma or GED required
Required Certification
Applicants must hold an active CPB (Certified Professional Biller – AAPC) certification at the time of application. This role is insurance A/R- and ERISA appeals-focused; coding-only certifications do not meet the minimum requirement.
The following certifications may be held in addition to CPB but do not replace it:
• CPC (AAPC)
• CBCS (NHA)
• CMRS (AMBA)
Certification status will be verified.
References
• 1–2 professional work references required
• References must be able to speak to insurance A/R experience, appeals experience, and reliability
Employment Conditions
• Employment is contingent upon successful completion of a formal background check
Important Disqualifiers
This role is not suitable for:
• Entry-level or junior billing roles
• Coding-only positions
• Charge posting–only or payment posting–only roles
• Contractors, agencies, or third-party billing companies
Applicants must submit a current resume outlining relevant insurance A/R and ERISA appeals experience and must have personally prepared and submitted ERISA appeals that resulted in payment.
U.S. work authorization required. No visa sponsorship.