Support the financial side of complex transplant care by helping ensure claims are accurate, payer requirements are met, and account issues are resolved.
This role combines insurance follow-up, denial management, appeals, billing review, and cross-functional collaboration in a specialized revenue cycle environment.
What you will do
- Follow up with commercial, Medicaid, and other payers to secure appropriate payment.
- Review and work claim denials, identify next steps, and prepare or support appeals.
- Analyze account activity, correspondence, payment information, and payer requirements.
- Compile and prepare patient charges and claims, including UB-04 and 1500 claim forms, as applicable.
- Manage billing according to contracts and follow up on outstanding correspondence or account needs.
- Perform specialized level III work and serve as a resource on non-routine situations.
- Collaborate with Physicians Billing Service, Admitting, outpatient areas, Patient Financial Services, and other departments.
- Participate in quality improvement, research, analysis, corrective action, and system improvement efforts.
Work environment
- Hourly, non-exempt individual contributor role in the Billing job family.
- Transplant work may include hospital, physician, and home health billing considerations.
Requirements & Qualifications
Required qualifications
- High school diploma or equivalent.
- 3+ years of work experience in a related job discipline.
Preferred qualifications
- Insurance company follow-up experience.
- Experience working denials, disputes, or appeals.
- Exposure to hospital, physician, home health, or related revenue cycle billing.
- Knowledge of cash posting or payment activity.
- Transplant billing experience is helpful but not required.
- Experience with multiple payer types.
Helpful skills
- Working knowledge of insurance follow-up and denial processes.
- Ability to recognize patterns in partial or conflicting information and apply established processes.
- Clear written communication for appeals, payer correspondence, and account documentation.
- Comfort working across payer types and billing settings.
- Organization, persistence, and collaborative problem solving.
Location
Cincinnati, Ohio, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago
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