Insurance Claims & Denials Specialist

Northeast Georgia Health System; United States; Remote; USD 45,000 - 70,000; Full time

Job summary

Northeast Georgia Health System is seeking an Insurance Specialist to be a primary contact for patients regarding insurance claims, denials, and re-determinations. You will handle credit balances, review prior billing activity, and apply payer guidelines to recover underpayments and support claim adjudication.

The role requires CPAR and CPB or CPC certification (or CPB/CPC within one year), a high school diploma or GED, and at least 3 years of medical billing/coding experience.

Qualifications

• CPAR and CPB or CPC certification required; CPB/CPC can be obtained within one year.
• High School Diploma or GED.
• Minimum 3 years medical billing and/or medical coding experience.
• HIPAA regulations knowledge and patient data protection.

Responsibilities

• Verifies and updates patient insurance coverage and rebills claims when appropriate.
• Resolve patient inquiries via phone and messages, deescalating complaints where possible.
• Review EOBs, perform posting corrections, and assist with denial follow-up.
• Maintain knowledge of billing regulations and organizational guidelines.
• Participate in department meetings and collaborate with care teams.

Skills

Medical billing

Medical coding

Customer service

HIPAA knowledge

Computer proficiency

Education

High School Diploma or GED

Job description

Northeast Georgia Health System is seeking an Insurance Specialist to be a primary contact for patients regarding insurance claims, denials, and re-determinations. You will handle credit balances, review prior billing activity, and apply payer guidelines to recover underpayments and support claim adjudication.

The role requires CPAR and CPB or CPC certification (or CPB/CPC within one year), a high school diploma or GED, and at least 3 years of medical billing/coding experience.