Billing Denials & Reimbursement Specialist (Hybrid)

ADP, Inc.; Santa Ana (CA); Hybride; USD 60 000 - 85 000; Plein temps

Résumé du poste

ADP, Inc. in Santa Ana, CA is seeking a Billing Problem Resolution Specialist to investigate, resolve, and prevent laboratory billing issues.

You will act as a liaison among patients, clients, health plans, laboratories, providers, and internal teams to ensure accurate billing and timely reimbursement. The role requires analyzing complex discrepancies, researching denials, preparing corrected claims, and contributing to revenue cycle improvements.

Qualifications

• High school diploma or equivalent.
• Minimum of two years in healthcare billing, medical claims processing, revenue cycle management, or insurance collections.
• Knowledge of medical terminology, insurance billing, and reimbursements.
• Experience researching and resolving claim denials and billing discrepancies.
• Strong analytical and problem-solving skills.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office applications, particularly Excel.
• Ability to prioritize workload and meet deadlines.

Responsabilités

• Investigate and resolve billing discrepancies, claim denials, and payment variances.
• Research payer policies, coding requirements, and reimbursement issues affecting claims.
• Review patient accounts to identify and correct demographic, insurance, or charge errors.
• Communicate with insurance carriers, clients, providers, and patients to obtain needed information.
• Analyze EOBs, remittance advice, denial codes, and payer correspondence.
• Prepare and submit corrected claims, appeals, and supporting documentation.
• Monitor aging accounts and follow up on unresolved issues.
• Collaborate with operations, client services, compliance, and finance to resolve systemic issues.
• Maintain detailed documentation within billing systems.

Connaissances

Analytical skills

Problem-solving

Excellent communication

Attention to detail

Independent with collaboration

Excel proficiency

Formation

Associate's or Bachelor's degree in Healthcare Administration, Business, Finance, or related field

Outils

Excel

Description du poste

ADP, Inc. in Santa Ana, CA is seeking a Billing Problem Resolution Specialist to investigate, resolve, and prevent laboratory billing issues.

You will act as a liaison among patients, clients, health plans, laboratories, providers, and internal teams to ensure accurate billing and timely reimbursement. The role requires analyzing complex discrepancies, researching denials, preparing corrected claims, and contributing to revenue cycle improvements.