Insurance Claims & Reimbursement Specialist

Renown Health; Reno (NV); On-site; USD 55,000 - 70,000; Full time

Job summary

Renown Health is seeking an Insurance and Claims Specialist to review and correct claim errors for timely submission and reimbursement. The role involves appealing denied claims and handling complex accounts to ensure accurate receivables.

Responsibilities include auditing denials, applying contract knowledge to maximize payments, and maintaining up-to-date knowledge of CPT/HCPCS, ICD, DRG, and HIPAA transactions. This is not direct patient care.

Qualifications

• Ability to read, write, speak, and understand English to perform duties safely.
• One year healthcare billing office experience with knowledge of government and third-party payors.
• Proficiency with Microsoft Office Suite for online learning and policy access.

Responsibilities

• Review and correct claim errors for first submission accuracy.
• Audit denials and variances to identify root causes and fix them.
• Provide contract knowledge to maximize reimbursement of claims.
• Resolve credit balances by reviewing payments and adjustments.
• Stay current with CPT/HCPCS, ICD, DRG, and HIPAA transaction sets.

Skills

English language proficiency

Education

Associates degree preferred

Billing certification may be accepted in lieu of experience

Tools

Microsoft Office Suite (Outlook, PowerPoint, Excel, Teams, Word)

Job description

Renown Health is seeking an Insurance and Claims Specialist to review and correct claim errors for timely submission and reimbursement. The role involves appealing denied claims and handling complex accounts to ensure accurate receivables.

Responsibilities include auditing denials, applying contract knowledge to maximize payments, and maintaining up-to-date knowledge of CPT/HCPCS, ICD, DRG, and HIPAA transactions. This is not direct patient care.