Healthcare Revenue Cycle & Denials Specialist

Unified Women's Healthcare; Virginia (MN); On-site; USD 52,000 - 75,000; Full time

Benefits offered by this job

Health Coverage

Paid Time Off

401(k) Plan

FSAs/HSAs

Disability Insurance

Employee Assistance Program

Job summary

Unified Women's Healthcare is seeking a Revenue Cycle Specialist to resolve claim issues, manage A/R, denials, and payment variances across internal and external teams. The role requires strong communication with practices and payers to resolve discrepancies and trends.

The ideal candidate has 2+ years in medical billing, claims, and denials, with OB/GYN billing experience preferred and familiarity with practice management systems and Salesforce CRM.

Qualifications

• Minimum 2 years experience interpreting insurance explanations of benefits and patient benefit plans.
• Minimum 2 years experience working with medical claims, billing, collections and appeals; OB/GYN preferred.
• Experience with healthcare practice management systems (Athenanet preferred).
• Experience with cloud-based CRM (Salesforce preferred).
• Excellent communication skills with internal and external customers.

Responsibilities

• Resolve Accounts Receivable and Collections.
• Review, follow up, and appeal denied claims according to standards.
• Determine accuracy of insurance payments and follow up on discrepancies.
• Initiate, follow up, and respond on payer reimbursement issues.
• Communicate with practices and payers regarding claim denials and payer trends.
• Analyze and review the quality of work by third parties.
• Build and generate reports as needed.

Skills

Accounts Receivable

Insurance Billing

AR Denials

Medical Claims

OB/GYN Billing

Salesforce

Excel

Verbal & Written Communication

Cross-functional Teamwork

Practice Management

Payer Portals

Billing & Coding

Education

High school diploma

Postsecondary degree preferred

Tools

Athenanet

Salesforce

Microsoft Excel

Job description

Unified Women's Healthcare is seeking a Revenue Cycle Specialist to resolve claim issues, manage A/R, denials, and payment variances across internal and external teams. The role requires strong communication with practices and payers to resolve discrepancies and trends.

The ideal candidate has 2+ years in medical billing, claims, and denials, with OB/GYN billing experience preferred and familiarity with practice management systems and Salesforce CRM.