Healthcare Claims & Reimbursement Specialist

Renown Health; Nevada; On-site; USD 28,000 - 36,000; Full time

Benefits offered by this job

Education Assistance

Paid Time Off

401(k) Company Match

Flexible Work Environment

Job summary

Renown Health is seeking an Insurance and Claims Specialist to review and correct claim errors, ensuring accurate, timely submission and follow-up with payors. You will appeal denied claims and manage difficult accounts deemed unpayable, while applying state/federal regulations related to contracts, CPT/HCPCS, ICD, DRG, and HIPAA transactions.

This role requires at least an associate degree (preferred) and healthcare billing experience, with strong proficiency in Microsoft Office and analytic

Qualifications

• Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively.
• Associates degree preferred.
• One year healthcare billing office experience with extensive knowledge of healthcare billing, government and third party payor requirements.
• Associate degree or certification in accredited billing certification may be accepted in lieu of years of experience.
• Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

Responsibilities

• Work assigned Work Queues to correct errors, ensuring accurate claims and reimbursement on first claim submission.
• Audit denials and payment variances to determine root cause and correction as required.
• Auditing payment variances ensuring appropriate reimbursement.
• Provide specific and in depth contract knowledge to ensure maximum reimbursement of healthcare claims.
• Resolve credit balances by reviewing payments, adjustments or transfers correcting the patient account to reflect an accurate account receivable balance.

Skills

English proficiency

Education

Associates degree preferred

Tools

Microsoft Office Suite

Job description

Renown Health is seeking an Insurance and Claims Specialist to review and correct claim errors, ensuring accurate, timely submission and follow-up with payors. You will appeal denied claims and manage difficult accounts deemed unpayable, while applying state/federal regulations related to contracts, CPT/HCPCS, ICD, DRG, and HIPAA transactions.

This role requires at least an associate degree (preferred) and healthcare billing experience, with strong proficiency in Microsoft Office and analytic