Collections & Denials Management Representative
Rochester Regional Health, Canton, New York, United States
Job Title:
Medical Billing and Denials Specialist
Department:
Revenue Cycle
Location:
SLH Regional Administrative Campus 6196 US 11 Canton, NY
Hours Per Week:
37.5
Schedule:
Monday- Friday 8 am - 4pm
SUMMARY 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.
RESPONSIBILITIES
Medical Billing & Claims Management : Submit and track insurance claims, resolve denials and billing edits, process remittances and adjustments, and ensure timely and accurate account resolution in line with payer requirements.
Appeals & Reimbursement Review : Conduct detailed reviews of denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to ensure successful claim outcomes.
Customer Service & Communication : Respond to patient inquiries, verify insurance eligibility and authorizations, and maintain thorough documentation while ensuring clear communication across Revenue Cycle teams.
Compliance & Operational Excellence : Maintain HIPAA confidentiality, meet productivity benchmarks, stay current with billing policies, and manage workload with strong time management, organization, and communication skills.
QUALIFICATIONS Required Qualifications:
None
Preferred Qualifications:
High school graduate or equivalent
Bachelor’s degree in healthcare or business administration
Minimum 1 year medical billing and denials, customer service and relevant finance experience in a health care organization a plus
Certification in medical billing
PHYSICAL REQUIREMENTS S - Sedentary Work - Exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
PAY RANGE $20.66 - $29.99
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Medical Billing and Denials Specialist
Department:
Revenue Cycle
Location:
SLH Regional Administrative Campus 6196 US 11 Canton, NY
Hours Per Week:
37.5
Schedule:
Monday- Friday 8 am - 4pm
SUMMARY 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.
RESPONSIBILITIES
Medical Billing & Claims Management : Submit and track insurance claims, resolve denials and billing edits, process remittances and adjustments, and ensure timely and accurate account resolution in line with payer requirements.
Appeals & Reimbursement Review : Conduct detailed reviews of denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to ensure successful claim outcomes.
Customer Service & Communication : Respond to patient inquiries, verify insurance eligibility and authorizations, and maintain thorough documentation while ensuring clear communication across Revenue Cycle teams.
Compliance & Operational Excellence : Maintain HIPAA confidentiality, meet productivity benchmarks, stay current with billing policies, and manage workload with strong time management, organization, and communication skills.
QUALIFICATIONS Required Qualifications:
None
Preferred Qualifications:
High school graduate or equivalent
Bachelor’s degree in healthcare or business administration
Minimum 1 year medical billing and denials, customer service and relevant finance experience in a health care organization a plus
Certification in medical billing
PHYSICAL REQUIREMENTS S - Sedentary Work - Exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
PAY RANGE $20.66 - $29.99
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