Claims Denial & Reimbursement Specialist

Prairie Ridge Health Inc.; Columbus (OH); On-site; USD 52,000 - 64,000; Full time

Job summary

Prairie Ridge Health Inc. in Columbus, OH, is hiring a Claims Resolution Specialist to join Business Services. This full-time role handles researching and resolving complex facility and professional insurance denials and ensures timely follow-up of claims.

You will interact with other teams to resolve errors, review accounts, and apply billing follow-up knowledge to maximize reimbursement across payors.

Qualifications

• High school diploma required.
• CPB certification within 18 months of hire preferred.
• Experience with hospital and professional claim forms; CPT/HCPCS/ICD-10 coding knowledge.

Responsibilities

• Research and resolve complex facility and professional insurance denials.
• Ensure timely follow-up of claims.
• Collaborate with other teams to resolve errors and optimize reimbursement.

Skills

Analytical thinking

Attention to detail

Communication

Billing follow-up

Education

High school diploma

CPB (Certified Professional Biller)

CPC (Certified Professional Coder)

Tools

Microsoft Excel

Job description

Prairie Ridge Health Inc. in Columbus, OH, is hiring a Claims Resolution Specialist to join Business Services. This full-time role handles researching and resolving complex facility and professional insurance denials and ensures timely follow-up of claims.

You will interact with other teams to resolve errors, review accounts, and apply billing follow-up knowledge to maximize reimbursement across payors.