A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims, and ensuring timely reimbursement for healthcare services. This role plays a critical part in the revenue cycle management of the healthcare organization by identifying trends in denials and taking corrective actions.
- Manage billing, claims processing, and denials workflows across inpatient, outpatient, critical access, and rural health settings.
- Submit and follow up on insurance claims, resolve denials and rejections, and prepare appeal letters with supporting documentation.
- Retrieve and update patient account statuses, process remittances, manage accounts receivable, and support accurate charge entry.
- Handle patient and payer inquiries, verify insurance eligibility and authorizations, and maintain HIPAA compliance.
- Use EMR systems, meet productivity benchmarks, and work effectively with cross-departmental teams.
Requirements & Qualifications
- Experience in medical billing and denials management.
- Knowledge of medical terminology, physician fee schedules, DRGs, and reimbursement procedures.
- Strong customer service, communication, organization, and multitasking skills.
- Ability to manage claims, appeals, account activity, and financial analysis.
- Familiarity with EMR systems and healthcare revenue cycle workflows.
- Preferred: bachelor's degree in healthcare or business administration.
- Preferred: certification in medical billing.
Benefits & Perks
- Full-time schedule, 40 hours per week.
- Monday through Friday, 8:00 AM to 4:00 PM.
- Opportunity to work within a healthcare revenue cycle environment.
- Eligible for additional pay components based on position details and FTE.
- Union: CSEA (MH) where applicable.
Location
New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago