Discover your 100% YOU with MicroSourcing!
Position: Medical Representative - Rejections Specialist
Work setup: Night shift | Work from home
Why join MicroSourcing
You'll Have
- Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
- A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
- Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
- Career Growth: Take advantage of opportunities for continuous learning and career advancement.
- Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.
Position Summary
The Rejections Specialist is responsible for identifying, analyzing, and resolving insurance claim rejections and denials within Waystar, Turnwell Mental Health's revenue cycle management platform. This role plays a critical part in maximizing reimbursement and minimizing revenue loss by working claims through the full correction and resubmission cycle in a timely and accurate manner.
Key Responsibilities
- Monitor and work the Waystar rejections and denials queue daily, prioritizing claims by payer, dollar amount, and timely filing deadlines
- Identify root causes of claim rejections (eligibility, authorization, coding errors, missing information, demographic mismatches, etc.) and take corrective action
- Correct and resubmit claims electronically through Waystar, ensuring all edits meet payer-specific requirements
- Review Explanation of Benefits (EOBs) and Remittance Advice (RAs) to determine appropriate appeal or resubmission strategy
- Collaborate with clinical, front desk, and authorization teams to resolve documentation or eligibility-related rejections
- Escalate complex denials to the Billing Manager or Appeals Specialist as appropriate
- Track and document all claim activity and resolution notes within Waystar and the practice management system
- Monitor timely filing limits by payer and flag at-risk claims proactively
- Identify trends in rejection patterns and communicate findings to leadership for process improvement
- Maintain working knowledge of mental health billing codes (CPT, ICD-10), modifiers, and behavioral health payer requirements
- Meet productivity and collection benchmarks established by the Revenue Cycle Manager
Qualifications
Required:
- Minimum 1–2 years of medical billing experience, specifically in rejections or denials management
- Hands-on experience working within Waystar (claim editing, status tracking, ERA/EOB review)
- Familiarity with behavioral health / mental health billing practices and payers
- Knowledge of CPT codes, ICD-10 diagnosis codes, and modifiers relevant to outpatient mental health
- Understanding of insurance claim lifecycle, payer portals, and ERA processing
- Strong attention to detail and ability to manage a high-volume queue
Preferred
- Experience with mental health or substance use disorder billing
- Familiarity with Medicaid, Medicare, and commercial payer behavioral health policies in Montana
- CPC, CPMA, or other medical billing/coding certification
- Experience with practice management systems (e.g., Valant, Therapy Brands, or similar EHR/PM)
Skills & Competencies
- Proficiency in Waystar for rejection management, claim editing, and secondary billing
- Strong analytical and problem-solving skills
- Excellent written and verbal communication
- Ability to work independently and manage competing priorities
- Collaborative, team-oriented approach
- Commitment to patient privacy and HIPAA compliance
Work Environment
This position is performed remotely. Standard business hours apply, with occasional flexibility required during month-end close or high-volume periods.
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About MicroSourcing
With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.
Our commitment to 100% YOU
MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.
At MicroSourcing, equality is not merely a slogan – it's our commitment. Our way of life. Here, we don't just accept your unique authentic self - we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100%!
For more information, visit https://www.microsourcing.com/
