Insurance Recovery & Denials Specialist

Northeast Georgia Health System; Oakwood (GA); On-site; USD 42,000 - 64,000; Full time

Job summary

Northeast Georgia Health System is seeking an Insurance Specialist to serve as the primary contact for patient questions on insurance claims, denials, coding, re-determinations, and settlements. You will review prior billing activity, correct errors, and support claim adjudication while ensuring HIPAA compliance and patient-centered service.

Responsibilities include rebilling, researching inquiries, and resolving underpayments, with strong communication and problem-solving skills in a fast-paced

Qualifications

• CPAR and CPB or CPC certifications; CPB/CPC can be obtained within one year of hire.
• Minimum 3 years of medical billing and/or medical coding experience.
• Strong knowledge of Revenue Cycle functions and HIPAA regulations.

Responsibilities

• Verifies and updates patient insurance coverage and rebills claims as appropriate.
• Researches and resolves patient inquiries via phone and electronic messages.
• Liaises with patients and payers to resolve insurance billing issues and review EOBs.
• Identifies and corrects posting errors and underpayments or denials within the appeal window.
• Adheres to quality and productivity standards and participates in department meetings.
• Maintains understanding of health insurance, billing regulations, and NGHS Financial Assistance Programs.

Skills

Customer service

Problem solving

Communication

Education

High School Diploma or GED

Job description

Northeast Georgia Health System is seeking an Insurance Specialist to serve as the primary contact for patient questions on insurance claims, denials, coding, re-determinations, and settlements. You will review prior billing activity, correct errors, and support claim adjudication while ensuring HIPAA compliance and patient-centered service.

Responsibilities include rebilling, researching inquiries, and resolving underpayments, with strong communication and problem-solving skills in a fast-paced