Billing & AR Specialist: Denials, Claims & Payments

Saint Peter’s Health Care System; Piscataway Township (NJ); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) match

Tuition assistance

Job summary

Saint Peter’s Health Care System is seeking a Billing Services Representative to join the Business Office in New Jersey. The role focuses on account accuracy, timely claim submissions, and denial management within a hospital billing environment.

Responsibilities include reviewing claims, monitoring codes and payments, managing denials, and coordinating with departments to correct accounts. Proficiency in Word/Excel and HIPAA compliance are required; one year of medical billing experience is

Qualifications

• Requires 1+ year of Medical Insurance Billing experience (hospital billing strongly preferred).
• Proficient in Microsoft Word and Microsoft Excel.
• Strong interpersonal skills and ability to work with Patient Accounts Personnel and outside agencies.
• Knowledge of collections, A/R follow-up and billing, third-party payers, State and Federal Agencies (constantly changing) with regards to Patient Accounting.

Responsibilities

• Ensure account accuracy.
• Review daily claims to ensure submissions are clean and timely.
• Monitor charges/modifiers/CPT-4s/HCPCS/payments/DRGs/ICD-10 coding.
• Review outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances.
• Submit timely and accurate adjustments/notes/patient balance transfers and medical record requests.
• Work with management team and notifying of notifying of issues that arise with payors/departments/etc
• Resolve account issues and problem solving independently whenever possible.
• Use technology provided (including hospital information system, contract management system, electronic billing system, payer websites and document imaging system.)
• Manage denials and appealing administrative claims.
• Understand denials and how they should be handled.
• Send clinical denials and downgraded claims to appropriate parties to ensure timely appeal.
• Ensure claims denied at time of billing are distributed to appropriate parties for review.
• Update and correct accounts with assistance of originating departments (charges/authorizations/insurance issues).
• Follow departmental and hospital policy and procedure (this includes HIPAA guidelines and Federal guidelines).
• Understand payor contracts and billing guidelines; revenue codes and payor specific requirements; and payor/plan codes.
• knowledge of Medicare and Medicaid

Skills

Interpersonal skills

Detail oriented

Deadline oriented

Tools

Microsoft Word

Microsoft Excel

Job description

Saint Peter’s Health Care System is seeking a Billing Services Representative to join the Business Office in New Jersey. The role focuses on account accuracy, timely claim submissions, and denial management within a hospital billing environment.

Responsibilities include reviewing claims, monitoring codes and payments, managing denials, and coordinating with departments to correct accounts. Proficiency in Word/Excel and HIPAA compliance are required; one year of medical billing experience is