Aspire Allergy & Sinus

Specialized allergy, sinus, and asthma care

Denials and Appeals Specialist

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeAustin, TX, USANo salary listed

About the Job

Requirements

Exceptional ability to investigate complex data sets, perform root cause analysis on denial trends, and independently solve ambiguous billing or reimbursement problems.
Expert-level mastery of insurance workflows, advanced appeal strategies, coding rules, and diverse payer reimbursement logic.
Ability to navigate high-dollar disputes and implement advanced resolution pathways under minimal supervision.
Ability to explain complex policy concepts clearly and serve as a technical resource and mentor to junior staff.
Ability to prioritize and manage multiple workflows and deadlines.
Ability to maintain effective working relationships with patients, medical staff, and the public.
Ability to react calmly and effectively in difficult or emergent situations, including de-escalating sensitive patient concerns.

Responsibilities

Resolve highly complex and high-dollar reimbursement issues.
Perform root cause analysis on denial trends and payer behavior.
Manage systemic payer issues affecting multiple claims or locations.
Serve as the escalation point for Level 1 and Level 2 Accounts Receivable Specialists, resolving complex patient account and payer concerns.
Handle sensitive and complex patient interactions, providing advanced problem-solving and de-escalation for challenging account issues.
Develop advanced appeal strategies and resolution pathways.
Interpret complex payer policies, coding rules, and reimbursement logic.
Identify breakdowns in payer processes and recommend corrective action.
Support process improvement initiatives across the revenue cycle.
Provide guidance on complex claim scenarios and payer disputes.
Review and approve account write-offs and adjustments up to $1,000; escalate amounts exceeding this threshold for management approval.
Assist with standard Level 1 and Level 2 Accounts Receivable responsibilities across all financial classes as business needs require.
Monitor, guide, and review the work of Level 1 and Level 2 Accounts Receivable Specialists on escalated, high-dollar cases to ensure accurate resolution.
Conduct one-on-one meetings with department and cross-departmental teams to share denial trends.

Aspire Allergy & Sinus is seeking a full-time Medical Accounts Receivable Specialist (Level 3) to serve as a subject matter expert responsible for resolving complex, high-dollar, and systemic reimbursement issues. This role evaluates assigned payer accounts, including working rejections, invalid and denied claims, appeals, escalated patient account concerns, and follow-up activities to bring accounts to final resolution in a timely manner and within industry-standard benchmarks. The Level 3 AR Specialist also identifies root causes of reimbursement challenges, supports Accounts Receivable operations across all financial classes as needed, and ensures compliance with industry regulations, practice protocols, and company policies while driving overall revenue cycle performance.

Schedule:
Monday-Thursday 8 am- 5 pm
Friday 8 am- 12 pm
(40 hour work week)

This position will be fully onsite at our HQ office located at 5929 Balcones Dr #200, Austin, TX 78731

Resolve highly complex and high-dollar reimbursement issues.
Perform root cause analysis on denial trends and payer behavior.
Manage systemic payer issues affecting multiple claims or locations.
Serve as the escalation point for Level 1 and Level 2 AR Specialists**, including the resolution of the most complex patient account and payer concerns.**
Handle sensitive and complex patient interactions, providing advanced problem-solving and de-escalation for challenging account issues.
Develop advanced appeal strategies and resolution pathways.
Interpret complex payer policies, coding rules, and reimbursement logic.
Identify breakdowns in payer processes and recommend corrective action.
Support process improvement initiatives across the revenue cycle.
Provide guidance on complex claim scenarios and payer disputes.
Review and approve account write-offs and adjustments up to $1,000; escalate amounts exceeding this threshold for management approval.
Assist with standard Level 1 and Level 2 Accounts Receivable responsibilities across all financial classes as business needs require.

Exceptional ability to investigate complex data sets, perform root cause analysis on denial trends, and solve ambiguous billing or reimbursement puzzles independently
Expert-level mastery of insurance workflows, advanced appeal strategies, coding rules, and diverse payer reimbursement logic
Strong capacity to navigate high-dollar disputes and confidently implement advanced resolution pathways under minimal supervision
Ability to articulate complex policy concepts clearly, serving as an approachable technical resource and mentor to junior staff
Excellent written and verbal communication skills
Ability to prioritize and manage multiple workflows and deadlines
Must possess the ability to maintain effective working relationships with patients, medical staff and the public
Must possess the ability to react calmly and effectively in a difficult or emergent situation, including de-escalating sensitive patient concerns.

Supervisory responsibilities:

Direct Supervision: This role does not have formal direct reports (e.g., hiring, firing, or formal performance reviews).
Functional Leadership: Acts as an informal technical authority and team lead within the AR department.
Escalation & Mentorship: Responsible for monitoring, guiding, and reviewing the work of Level 1 and Level 2 AR Specialists on escalated, high-dollar cases to ensure accurate resolution.
Conduct 1:1 meetings with department and cross-departmental teams to share denial trends.

About the Company

Aspire Allergy & Sinus

Specialized allergy, sinus, and asthma care

Aspire Allergy & Sinus runs a network of clinics that diagnose and treat allergies, sinus conditions, and asthma across patients of all ages. Its services include comprehensive allergy testing, personalized treatment plans, and in-office sinus procedures, providing a one-stop pathway from testing to treatment. The company delivers direct patient care through its clinics, focusing on specialty healthcare to streamline the patient experience and improve outcomes in the regions it serves. Unlike general practitioners or solo practices, Aspire Allergy & Sinus combines testing, clinical care, and procedural services under one specialty network to offer coordinated allergy and sinus care.

Company size: 51-200
Company stage: Not listed
Total funding: Not listed
Headquarters: Austin, TX
Founded: 2012

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