Billing & Denials Specialist: Claims & Compliance

Talentify; Brick Township (NJ); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k) Plan

Paid Time Off

Paid Holidays

Employee Assistance Program

Employee Discounts

Employee Referral Program

Job summary

Talentify is seeking a Billing Specialist to ensure timely submission of claims and follow-up on reimbursements. You will review documentation for payer alignment, monitor denials, and stay current with MCO billing requirements.

The role emphasizes CQI involvement, collaboration with the Billing Manager, and adherence to billing KPIs. English/Spanish bilingual preference and MS Office proficiency are valued.

Qualifications

• High School diploma or equivalent required.
• CPC certification required for all CPCs.
• Medical Billing Certification preferred or relevant experience.
• 1–2 years of experience in a billing department or healthcare setting.
• Bilingual in English and Spanish preferred.
• Proficiency in Microsoft Office 365 required.

Responsibilities

• Ensure timely and accurate submission of claims to payers.
• Review coder documentation for alignment with guidelines and escalate discrepancies.
• Stay updated on MCO changes and billing requirements.
• Manage payer denials by reviewing, correcting, and resubmitting claims.
• Monitor aging reports and follow up on delinquent accounts with patients and insurers.
• Post payments, adjust contracts, and handle patient refunds.
• Provide excellent customer service for billing inquiries.
• Contribute to CQI by identifying billing process improvements.
• Track payer trends and implement faster claims resolution.

Skills

Bilingual English/Spanish

Education

High School diploma or equivalent

CPC certification

Medical Billing Certification

Tools

Microsoft Office 365

Job description

Talentify is seeking a Billing Specialist to ensure timely submission of claims and follow-up on reimbursements. You will review documentation for payer alignment, monitor denials, and stay current with MCO billing requirements.

The role emphasizes CQI involvement, collaboration with the Billing Manager, and adherence to billing KPIs. English/Spanish bilingual preference and MS Office proficiency are valued.