Medical Billing Specialist, Denials & Appeals

About us: At TLNT, we believe that recruitment is more than just filling roles — it’s about connecting humans with humans. We’re a people-first organization partnering with top U.S. companies to help them grow by attracting exceptional talent, and we know that the right content can open the right doors.

This is an excellent opportunity to grow your career with a leading US-based company — fully remote, on a small team where you work directly with the CEO and your work is visible from day one.

About our partner: Join a specialized U.S. healthcare revenue cycle company focused exclusively on complex, high-value surgical care. Rather than processing claims in volume, the team engineers reimbursement outcomes case-by-case, managing each claim's full lifecycle from pre-service positioning through appeals and resolution, so surgical providers get paid what their work is actually worth.

About the role: This role owns the payment side of the revenue cycle for complex surgical cases, start to finish. That means resolving claim rejections, processing same-day remittances, running denial and underpayment appeals end to end, and keeping a deadline calendar with zero exceptions.

When a payment doesn't match what the claim actually supports, the Specialist digs in: verifies the shortfall, documents it, and either builds the appeal or hands the Chief Executive a sharp, decision-ready summary. At its core, this is investigative work — reading what the payer really did, figuring out why it's wrong, and making the case that fixes it.

We're looking for someone who already speaks the language of US medical billing fluently: reading an EOB or X12 835 without help, decoding CARC and RARC codes on sight, and chasing open balances because it's second nature, not a task list item.

What You'll Do

- Review claim acknowledgment and rejection reports (277CA)



each morning; identify root causes and prepare corrected or replacement claims (837) before rejections mature into denials.
- Process electronic remittances (ERA/835) and paper EOBs on the day of receipt, reconciling amounts paid against amounts properly payable, line by line.
- Resolve every underpayment and denial you identify through one of three documented outcomes: appeal, escalation, or reasoned closure.
- Prepare and submit denial and underpayment appeals; calendar each payer response deadline; pursue every appeal to a written resolution on a fixed cadence.
- Interpret plan documents and payer medical policies against the clinical record to determine why a claim paid as it did, and select the strongest ground for response.
- Maintain the deadline calendar for the full caseload: filing windows, response dates, and re-check dates, with proactive escalation of any item approaching its window unworked.
- Conduct claim-status calls with US payers and obtain operative reports and clinical records from surgical practices, documenting every contact the same day.
- Maintain the firm's payments, appeals, and receivables correspondence and keep the case platform current at all times. Clients read what you write.

What You Bring

- A minimum of two years, and preferably five or more, of hands-on US medical billing on the payment side: 835/ERA and EOB review, CARC and RARC interpretation, 277CA acknowledgment work, denials management, accounts receivable follow-up, and appeals, working directly with US payers. Command of the fundamentals is a condition of candidacy; the firm does not teach them.




- Intellectual sharpness. The ability to read a payer policy or plan provision, extract the operative language, and construct the argument that follows from it. This is thinking work, performed to an exacting standard.
- Professional English at C1 or above, with particular strength in writing. Appeals are formal persuasive documents that US insurance carriers read and act upon.
- Established payer telephone experience and fluency with major carrier portals (Availity and comparable systems).
- Tenacity: sustained, documented follow-through on every open item until it is resolved, without prompting.
- Exacting process discipline: calendars, checklists, and same-day documentation as standing practice rather than aspiration.
- A quiet, private home office with reliable high-speed internet, and willingness to execute confidentiality and HIPAA agreements, complete compliance training, and pass a background check.
- Preferred qualifications
- Out-of-network or surgical specialty billing experience.
- 837P/837I claim submission and clearinghouse experience (Availity, Optum, Waystar, or comparable).
- Appeals drafted personally that overturned a denial or recovered an underpayment; redacted examples are welcome at interview.

Salary & Perks

- Competitive USD Pay: We hire top talent and compensate accordingly.
- This is a full-time, long-term engagement with room to grow
- Target start date: September 2026.
- The position is immediately available and requires entering into an independent contractor agreement.
- 100% remote — open to LATAM, with Mexico strongly preferred (Monterrey, Guadalajara, CDMX).
- Monday through Friday, 7:00 a.m. to 5:00 p.m. US Central Time.

Ready to apply? We’d love to hear your story. The next step is a short application where you can share more about your background and upload your resume in English.

📌 Medical Billing Specialist, Denials & Appeals (Nuevo León)
🏢 TLNT Group
📍 Nuevo León