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Medical Billing and Denials Specialist

Rochester Regional Health

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 key part in revenue cycle management by identifying denial trends and taking corrective actions.

Key Responsibilities

  • Manage medical billing activities across inpatient, outpatient, critical access, and rural health claims.
  • Submit and follow up on insurance claims, resolve denials and rejections, and prepare appeal letters with appropriate supporting documentation.
  • Retrieve and update patient account statuses, process remittances, manage accounts receivable, and support accurate charge entry.
  • Answer patient and payer inquiries, verify insurance eligibility and authorizations, and maintain HIPAA-compliant documentation.
  • Use EMR systems, meet productivity benchmarks, and work effectively in a fast-paced administrative healthcare setting.
Requirements & Qualifications
  • Bachelor's degree in healthcare or business administration preferred.
  • Experience in medical billing and denials management preferred.
  • Customer service and healthcare finance experience are a plus.
  • Certification in medical billing preferred.
  • Knowledge of medical terminology, physician fee schedules, DRGs, reimbursement procedures, and claims processing.
  • Strong organizational, multitasking, and communication skills.
  • Ability to work with EMR systems and meet productivity standards.

Location

New York, US

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

No

Posted

1 week ago

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