Expert Orthopedic Biller — Denials, Appeals & Prior Auth (Part-Time, Remote)

Description Mira Health is a US health-tech startup building AI tools for orthopedic practices. Our AI analyzes denied claims and identifies recovery opportunities — we need an experienced US-medical-billing specialist to verify the AI's findings. You'll work a defined queue with clear templates and escalation rules, directly supporting a US orthopedic practice account. What you'll do 1. Verify AI-flagged denials in payer portals and Availity: confirm claim status, denial/remark codes, and timely-filing windows. 2. Prepare appeal packets from our templates (attach op notes, letters of medical necessity, auth records) and submit corrected claims and appeals via clearinghouse and payer portals. 3. Run the follow-up queue: status checks, documenting payer responses, moving claims to resolution. 4. Log every claim touched in our tracking system with standardized fields — accuracy of this log is a core job duty. Requirements 5. 3+ years of hands-on US medical billing, including denial follow-up and appeals. Orthopedic or surgical specialty experience strongly preferred. 6. Daily working experience with Availity and major payer portals (UHC, Aetna, Cigna, BCBS plans). 7. Understanding of CPT/ICD-10, modifiers, CARC/RARC denial codes, and timely filing rules. 8. Excellent written English; extremely detail-oriented and process-disciplined. 9. Able to overlap at least 3 hours/day with US Eastern business hours. Logistics 10. 15–18 hrs/week to start, long-term engagement with room to grow. We provide software access; HIPAA confidentiality agreement required. 11. Short paid trial task (claim verification exercise) for finalists. To apply, answer these 3 questions 1. Describe your US, ORTHOPEDIC medical billing experience: payers, and which portals you've worked in daily. 2. Describe how you use AI day-to-day. 3. What information would you provide to a client for them to be prepared for a peer-to-peer?