Description
Position Overview:
We are seeking a detail-oriented Denials Specialist to join our team. The ideal candidate will be responsible for accurately processing medical claims, review and follow up on denied or rejected claims, handling insurance reimbursements, and ensuring timely patient billing.
Key Responsibilities:
- Prepare and submit claims to Medicare, Medicaid, private insurance carriers, no fault and workers comp insurance carriers
- Submit appeals and follow up on denied or rejected claims to ensure timely resubmission.
- Verify and process patient insurance information, ensuring accuracy in billing codes (CPT, HCPCS, ICD-10).
- Post payments and adjustments while reconciling accounts receivable.
- Handle patient billing inquiries and set up payment plans as necessary.
- Maintain compliance with healthcare regulations, including HIPAA and payer guidelines.
- Work closely with the revenue cycle team to optimize reimbursement and minimize claim denials.
Qualifications:
- Experience:
- Minimum 2-3 years of medical billing experience, preferably in orthopedics
- Experience with orthopedics and pain management claims a plus
- Education: High school diploma required; associate's degree or certification in medical billing/coding preferred.
- Technical Skills: Proficiency in billing software and knowledge of ASC-specific coding.
- Soft Skills: Strong attention to detail, problem-solving skills, and ability to work in a fast-paced environment.
Work arrangement:
- Fully on-site
- Work hours: Flexible within an 8 AM - 4:30am (half hour lunch) or 8:30-5pm
We are an equal opportunity employer and comply with all applicable federal, state, and local fair employment practices laws. We strictly prohibit and do not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex, sexual orientation, gender (including gender identity and expression), marital or familial status, age, physical or mental disability, perceived disability, citizenship status, service in the uniformed services, genetic information, height, weight, or any other characteristic protected under applicable federal, state, or local law. Applications from members of minority groups and women are encouraged.