Insurance Claims & Denials Specialist

SIU Medicine; Springfield (IL); On-site; USD 40,000 - 55,000; Full time

Job summary

SIU Medicine in Springfield, IL is seeking a Billing Specialist to examine explanations of benefits, review outstanding invoices, and determine actions to maximize third-party payments. This on-site role focuses on denial management and follow-up with payers.

You will access patient accounts in the billing system, resubmit claims, adjust as needed, and coordinate with coding staff. A healthcare accounting background is preferred.

Qualifications

• Experience with explanation of benefits and denials workflow.
• Familiarity with processing EOBs and billing actions.
• Ability to access and navigate billing systems accurately.

Responsibilities

• Review explanations of benefits (EOB) for denials and access patient accounts in the billing system.
• Determine necessary actions, resubmit, adjust, or write-off as directed.
• Bill secondary insurance when appropriate and transfer charges as needed.
• Order and retrieve medical notes; submit denial information to coding staff.
• Resubmit claims based on reviewer input; balance daily batches and entries.

Skills

Effective communication

Keyboarding

Detail-oriented

Meet deadlines

Multi-tasking

Education

College coursework in health-related field

Associate's Degree

Tools

Billing system

Job description

SIU Medicine in Springfield, IL is seeking a Billing Specialist to examine explanations of benefits, review outstanding invoices, and determine actions to maximize third-party payments. This on-site role focuses on denial management and follow-up with payers.

You will access patient accounts in the billing system, resubmit claims, adjust as needed, and coordinate with coding staff. A healthcare accounting background is preferred.