Billing & Utilization Specialist: Claims & Authorizations

Prestera Health Services; Huntington (WV); On-site; USD 31,000 - 42,000; Full time

Job summary

Prestera Health Services is seeking an Administrative billing professional in Huntington, WV. The role focuses on claims processing, payer communications, and accurate posting of payments and adjustments to patient accounts.

The position requires a high school diploma with on‑the‑job billing knowledge; experience in medical billing is preferred, and proficiency in Word, Excel, and PowerPoint is expected. Work is performed in a typical office environment with day shifts.

Qualifications

• High school diploma or GED with on‑the‑job training in billing practices.
• Experience in medical billing or revenue cycle operations is preferred.
• Proficiency in Microsoft Word, Excel and PowerPoint with basic reporting skills.

Responsibilities

• Ensures accurate claims processing and follow up.
• Researches and resolves issues with claim rejections or other billing issues.
• Performs electronic and manual posting of both insurance and persons served payments/adjustments to individual’s accounts.
• Tracks outstanding claims, investigates issues, and coordinates corrections or appeals.
• Prepares, reviews, and submits claims with accuracy and adherence to payer requirements.
• Utilizes EHR optimally to audit claim status and troubleshoot issues.
• Provides professional and effective communication with internal and external customers as related to individual accounts.
• Creates and issues invoices and payment reminders to persons served.
• Processes credit memos and prepares account statements.
• Monitors account details for non-payments and irregularities.
• Communicates with payers, staff, and persons served to clarify documentation, eligibility, service, or claim needs.

Skills

Billing processes

Revenue cycle

MS Word

MS Excel

MS PowerPoint

EHR systems

Scheduling systems

Education

High School diploma or GED

Tools

Word

Excel

PowerPoint

EHR/ Scheduling systems

Job description

Prestera Health Services is seeking an Administrative billing professional in Huntington, WV. The role focuses on claims processing, payer communications, and accurate posting of payments and adjustments to patient accounts.

The position requires a high school diploma with on‑the‑job billing knowledge; experience in medical billing is preferred, and proficiency in Word, Excel, and PowerPoint is expected. Work is performed in a typical office environment with day shifts.