Responsible for non-complex electronic and paper claim submissions to insurance payers. Coordinates required information for filing secondary and tertiary claims, reviews and analyzes claims for accuracy, and makes charge corrections as needed to ensure billing invoices are correct.
Follows up with payers on unresponded claims, works denied claims using correct coding and payer guidelines, and coordinates appeals or charge corrections when necessary. Partners with Insurance Billing Specialist II, Denial Resolution staff, and other Guthrie departments to resolve billing inquiries and support revenue cycle workflows.
Provides responses to insurance companies, government agencies, and internal Guthrie Medical Group offices, and handles correspondence from insurance carriers including requests for supportive documentation.
Education and Certification
- High school diploma required
- CPC, CCA, RHIA, or RHIT certification in medical billing and coding preferred
- Associate degree preferred
Experience and Skills
- Strong organizational and customer service skills
- Experience with Microsoft Word and Excel required
- Prior experience in a high-volume, fast-paced environment preferred
- Knowledge of billing, coding, reimbursement policies, and payer guidelines
- Familiarity with Epic system functions preferred
Key Responsibilities
- Work pre-AR edits, paper claims, reports, and work queues
- Research rejections and follow up on rejected or non-responded claims
- Perform charge corrections, billing edits, and insurance eligibility checks
- Provide backup support for Central Charge Entry and Cash Applications
- Manually enter charges and post insurance and patient payments
- Prepare spreadsheets and manipulate data for project work
- Resolve credit balances and process invoice adjustments within policy guidelines
Location
Pennsylvania, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 week ago