Job description

Medical Billing/ Denial Specialist

The Company:

Since 1975, Elizabeth Wende Breast Center has been serving the greater Rochester, NY area with superior breast imaging technology and patient care. As the first dedicated breast clinic in the United

States, EWBC is a committed leader in the field of breast imaging and breast cancer diagnosis.

The Position:

Breast Imaging practice seeking a full time a Medical Billing Collections and Denial Specialist to add to our experienced Billing Department. This position is responsible for overseeing patient overdue collection and analyzing trends and coding issues resulting in insurance denials. The position reports directly to the Billing Manager. Communication skills with coworkers and patients are vital to improve processes and maintain quality customer relations. Requires strong organizational skills, critical thinking, and the ability to produce, interpret and present detailed billing activity reports.

General Responsibilities and Duties:

Denials and Claim Resolution:

• Daily review of insurance claims denials. Reviews, researches, and resubmits required documentation for denied claims to support payment from insurance providers.
• Follow up on unpaid/denied insurance claims. Resolves unpaid claims which have not been paid/rejected within a predetermined period through appeals process.
• Comfortable communicating with insurance provider representatives by email, telephone or virtual/in-person meeting to identify and ensure payment of claims.
• Understands in detail insurance and billing procedure guidelines when resubmitting claims and appeals.
• Prepares reports for management to document recurring problems and identifies the source of reimbursement delays. Works closely with management to ensure effective communication and education of staff.

Daily as Assigned:

• Claim Processing
• Process all claims, ensuring diagnosis and procedure codes, charges and modifiers are correct
• Troubleshoot and correct any problems that prevent a claim from being released for acceptance by insurance carriers
• Insurance and Patient payment posting
• Post payments and resolve unpaid, overpaid, or unreconciled insurance claims o Maintain a detailed knowledge of insurance regulations, billing procedures, and coding guidelines which affect insurance AR payments

Qualifications:

• CMC or CPC with experience in Radiology Billing preferred
• Experience with ledger resolution helpful
• Excellent communication skills both written and verbal, and internal personal skills
• Ability to multi-task, use critical thinking, familiar with Excel

Job Type: Full-time

Pay: $18.00 - $21.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

COVID-19 considerations:
Mask wearing

Work Location: One location

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