Medical Claims Billing Specialist (Canada)

The role

You will submit medical claims, follow up with insurance payers, and resolve denials. This role supports Revenue Cycle Management operations for Medicare and commercial insurance plans.

What you will do

• Submit medical claims accurately and efficiently to insurance payers
• Review, track, and follow up on denied, rejected, unpaid, or stale claims
• Work directly with insurance companies to resolve billing and reimbursement issues
• Identify and resolve claim errors, eligibility issues, authorization gaps, and payer rejections
• Submit corrected claims and manage appeals when necessary
• Maintain accurate documentation and claim status updates across internal systems
• Monitor aging claims and proactively escalate high-risk accounts or payer issues
• Partner closely with intake, credentialing, clinical, and operations teams to resolve claim blockers quickly
• Ensure timely and accurate workflows related to reimbursement and collections
• Continuously improve billing workflows, operational efficiency, and claim turnaround times

Required qualifications

• Prior experience in U.S. healthcare billing or revenue cycle management is required
• Strong understanding of claims submission, denials management, appeals, and payer follow-up workflows
• Extremely detail-oriented and organized
• Strong written and verbal English communication skills
• Comfortable handling high-volume operational work with speed and accuracy
• Ability to work independently in a fast-paced environment

Nice to have

• Experience working with Medicare and commercial insurance payers
• Experience using EHRs, billing systems, clearinghouses, or insurance portals

Benefits

• Remote-first team

About the company

Sailor Health envisions a world where every senior has seamless access to compassionate, effective, and personalized mental health care.