Priority Claims Specialist III

About Hanger

Hanger, Inc. is a leading provider of orthotic and prosthetic services and products, known for advanced O&P solutions, clinically differentiated programs, and strong customer support. Its Patient Care segment operates the largest network of O&P clinics in the country, while its Products & Services segment supplies branded and private-label devices, components, and rehabilitative solutions. Backed by more than 160 years of clinical expertise and innovation, Hanger aims to advance the orthotic and prosthetic market through better care, stronger outcomes, improved service, and greater value.

Role overview

The Priority Claims Specialist III will work remotely as part of a centralized revenue cycle team, focusing on high-value medical collections. The position is responsible for making sure services are paid accurately, on time, and with complete documentation, while following applicable laws, regulations, and Hanger policies. This role requires careful handling of adjustments, refunds, and write-offs in line with standard operating procedures, along with clear communication with internal and external partners. The schedule is Monday through Friday on a day shift.

What you'll do

• Use the billing and collections platform to locate and resolve claims that are unpaid, underpaid, or denied.
• Check explanation of benefits and related insurer correspondence to confirm reimbursement is correct under contract terms and applicable rules.
• Contact payers through portals, phone, email, and fax to move claims toward resolution.
• Spot billing mistakes and submit corrected claims to insurers.
• Track accounts carefully and provide prompt follow-up until each issue is closed.
• Prepare and manage appeals and disputes.
• Escalate accounts receivable concerns that could lead to delays in payment or write-offs.
• Record findings clearly and thoroughly in system notes and documentation.
• Research payer manuals and guidelines to support claim resolution.
• Process adjustments in the system when needed.
• Send medical records when requested.
• Resolve open receivables and answer questions from customers or outside collection resources.
• Focus primarily on complex denials and appeals.
• Review assigned encounters and reports, then follow through on any issues until resolved.
• Work with Patient Care Clinics on collection-related matters.
• Investigate and correct deficiencies to ensure they are fully addressed.
• Maintain working knowledge of DMEOPS CPT and ICD-10 coding.

Requirements

• High school diploma or equivalent.
• At least 4 years of relevant experience handling payer policies, reimbursement processes, medical policy, and appeal requirements.
• Experience with NextGen and/or OnBase is preferred.
• Strong attention to detail and the ability to spot patterns quickly.
• Clear verbal, written, and interpersonal communication skills.
• Working knowledge of appeals, reimbursement, LCDs, and policy articles.
• Familiarity with medical terminology.
• Self-directed approach with the ability to take initiative and solve problems proactively.
• Ability to manage multiple tasks at once.
• Strong ownership and accountability for meeting deadlines.
• Working knowledge of Microsoft Office applications.
• Experience with EHR systems such as OPS and NextGen.
• Ability to transfer data into online records management platforms such as OnBase.
• High ethical standards when handling confidential patient and billing information.
• Ability to communicate effectively by phone and in writing, and to follow both written and verbal instructions.
• Comfort working under pressure in a fast-paced environment.
• Resourceful, flexible, and collaborative approach to working with patients, insurers, and coworkers.
• Strong understanding of state, federal, and regional collection and reimbursement laws, HIPAA, and medical insurance rules and terminology including CPT, ICD-9, HCPCS, modifiers, coding, and documentation guidelines for private, state, and federal plans.
• Proficiency with Windows-based office tools such as Word, Excel, PowerPoint, email, and automated billing systems.
• Excellent organization and multitasking skills with strong detail orientation.
• Commitment to patient-centered service, open collaboration, continuous improvement, and strong results.

Compensation

The posted hourly pay range is $18.00 to $26.00, plus an annual bonus of up to 5% of base pay depending on bonus criteria. The range is provided to meet wage transparency requirements and may vary based on skills, experience, knowledge, geographic location, and other factors.

Benefits and perks

• Competitive compensation package.
• 8 paid national holidays and 4 additional floating holidays.
• Paid time off including vacation and sick leave.
• Medical, dental, and vision coverage.
• 401(k) savings and retirement plan.
• Paid parental bonding leave for new parents.
• Employee referral bonus program.
• Mentorship opportunities for mentors and mentees.

Equal opportunity

Hanger provides equal employment opportunity and does not discriminate or harass based on race, religious creed, color, age, sex, sexual orientation, gender identity, national origin, religion, marital status, medical condition, physical or mental disability, military service, pregnancy, childbirth-related conditions, special disabled veteran status, or any other classification protected by federal, state, or local law. The company also follows all applicable fair employment laws and prohibits retaliation for reporting or supporting discrimination or harassment complaints.

Reference

#ERF-HRC