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About the Role

The Denials & AR Recovery Specialist owns the recovery of insurance revenue that does not get paid cleanly on the first pass. You will work denied and underpaid claims to resolution, file appeals within payer deadlines, follow up on aging accounts receivable, and feed denial patterns back to the coding team so preventable denials stop at the source. This is a hands-on, metrics-driven role with a direct and measurable impact on cash collected.

Responsibilities

Work daily queues of denied, rejected, and underpaid claims, prioritizing by dollar value and by timely-filing and appeal deadlines.
Review remittances (ERAs and EOBs) and interpret CARC and RARC denial codes to determine the true root cause of each denial.
Prepare and submit payer-compliant appeals supported by clinical documentation, medical necessity rationale, and payer policy or contract language.
Correct and resubmit claims where the issue is a billing, coding, demographic, or eligibility error, routing coding questions to the coding team.
Track every claim through to resolution rather than resubmitting and moving on.
Monitor and work aging AR, following up with payers by portal, phone, and written correspondence until accounts are resolved.
Identify and pursue underpayments against expected allowed amounts and contracted rates.
Escalate systemic payer issues (recurring denials, payer processing errors, contract disputes) to the RCM Lead with supporting data.
Categorize denials by reason, payer, provider, and CPT code, and surface the top recurring drivers each month.
Partner with the coding and billing team to fix denial causes upstream, so the first-pass clean-claim rate improves as volume grows.
Flag any coding or documentation patterns that could create compliance or audit exposure, including E&M level and modifier issues.
Document all activity, notes, and outcomes in the billing system accurately and in real time.
Report on denial rate, denial dollars recovered, appeal success rate, and days in AR, and contribute to weekly team reviews.
Maintain patient and health information in line with HIPAA and company privacy and security policies.

Requirements

2+ years of medical billing, claims, denials, or AR follow-up experience, ideally including commercial payer appeals.
Working knowledge of the full revenue cycle and of CPT, ICD-10, and HCPCS coding concepts.
Ability to read remittances and act on CARC/RARC denial codes, knowing the correct next step for each (appeal, correct and resubmit, write off, escalate).
Familiarity with payer portals, clearinghouses, and billing or practice-management systems.
Comfort with spreadsheets for tracking, prioritizing, and reporting on claim work.
Strong written communication for appeal letters, and persistence and attention to detail under deadline pressure.
High school diploma or equivalent.

Skills

Medical billing
Claims processing
Denial resolution
AR follow-up
Commercial payer appeals
Revenue cycle management
CPT coding
ICD-10 coding
HCPCS coding
Remittance interpretation
CARC/RARC denial codes
Payer portals
Clearinghouses
Billing systems
Practice management systems
Spreadsheet proficiency
Written communication
Attention to detail
HIPAA compliance

Location

San Francisco, CA

Work Type

In-person
Full-time

Experience Level

2+ years

Education Level

High school diploma or equivalent
Associate or bachelor's degree in healthcare administration, business, or a related field (preferred)

Salary/Compensations

$80,000 - $100,000

Benefits

Opportunity to specialize further or move into a senior or lead denials position.

About the Company

Healthcare is broken at the first step: patients can't find the right care, understand what it costs, or access the medications they need. Mochi Health is fixing this.
We're building an AI-driven marketplace that makes healthcare discoverable—connecting patients to the right providers, transparent pharmacy pricing, and affordable medications.
Our platform does what legacy healthcare can't: it gives patients transparent pricing before they pay, personalized medication management that follows them across providers, and long-term access to their own medical records.
We're proving that healthcare can be more affordable, more human, and far more intuitive than what exists today.
Join a team that's rebuilding healthcare from the patient up. At Mochi Health, you'll work alongside people who value bold thinking, inclusive collaboration, and getting meaningful work into the world.
If you want to do the most impactful work of your career, this is where to do it.
Mochi Health is an in-person company based in San Francisco, CA. Our team works together in person five days a week to foster collaboration, innovation, and strong connections.
We believe that face-to-face interaction builds a culture of excellence and allows us to deliver the best outcomes for the patients and providers we serve.

Equal Opportunity

Mochi Health is an Equal Opportunity Employer. We make all employment decisions based solely on merit. We provide equal employment opportunities to all applicants and employees without discrimination on the basis of race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, disability status, or any other applicable legally protected characteristic. We prohibit any form of discrimination or harassment. This policy applies to all terms and conditions of employment, including hiring.
Mochi Health complies with the Americans with Disabilities Act (ADA), as amended by the ADA Amendments Act, and all applicable state or local laws. We will reasonably accommodate qualified individuals with a disability during the application process and throughout employment as required by law.
If you need any assistance or accommodations due to a disability, please contact us at hr@joinmochi.com.