Role OverviewA 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.
What You Will Do
Proficient in billing, claims processing, denials management, and knowledge of medical terminology, physician fee schedules, DRGs, and reimbursement procedures. Submits and follows up on insurance claims; resolves denials and rejections; prepares appeal letters with proper documentation and cross-department coordination.
Why It Might Be a Fit
This role plays a critical part in the revenue cycle management of the healthcare organization by identifying trends in denials and taking corrective actions. Strong organizational, multitasking, and communication skills are required.
Requirements
- Proficient in billing, claims processing, denials management, and knowledge of medical terminology, physician fee schedules, DRGs, and reimbursement procedures.
- Certification in medical billing
- Bachelor’s degree in healthcare or business administration
- Experience in medical billing and denials, customer service and relevant finance experience in a health care organization a plus
Benefits
- Dental insurance
- Vision insurance
- Health insurance
- Paid time off
- Retirement plan
- Life insurance
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