Medical Billing Specialist

Position Overview. We are looking for a detail-oriented and experienced Patient Account Representative II to join our team. If you have a strong understanding of Revenue Cycle Management processes, especially in handling denials and appeals, we would love to hear from you.

• Analyze denials and determine the best course of action for appeal or resubmission.
• Prepare and submit accurate and compliant appeals for denied claims.
• Collaborate with billing, coding, and clinical staff to gather necessary information for appeals and resolve denial issues efficiently.
• Maintain detailed records of denial cases, including appeals filed and communications with insurance representatives.
• Monitor the status of appealed claims and follow up with insurance representatives to expedite resolution.
• Generate and analyze reports on denial trends, identify root causes, and recommend process improvements.

• High school diploma or equivalent.
• 2 years of current experience in claims processing and denials management.
• 1 year of current experience with EPIC.
• Recent experience working with the EPIC EMR system.

• Ability to analyze denial reasons, identify trends, and develop strategies to minimize denials.
• Excellent written and verbal communication skills for effective communication with internal staff and insurance representatives.
• Strong attention to detail and accuracy in documentation and appeals submissions.
• Ability to collaborate effectively with multidisciplinary teams to achieve common goals.
• Thorough understanding of billing regulations, coverage guidelines, and the appeals process.

• Sitting: 90%
• Standing/Walking: 10%
• Occasional lifting/carrying of supplies and paper weighing up to 40 pounds.
• Occasional pushing/pulling to move supplies and equipment.
• Occasional climbing of stairs to reach other levels of the building.
• Occasional stooping/kneeling/bending/crouching to file in low cabinets, purge old bills, and print forms.
• Occasional reaching/handling/fingering to complete paperwork, use computers, file, and answer telephones.
• Frequent talking/hearing/seeing to interact with staff and customers to complete assigned tasks.

Inside

Location:

Onsite or Remote