Medical Billing & Denials Specialist

Chotahealth; Madisonville (TN); Hybrid; USD 22,000 - 26,000; Full time

Job summary

Chotahealth in Madisonville, TN is seeking an Insurance Claims Specialist to support follow-up on claims and denials, and to post insurance and patient payments. Responsibilities include charge entry and electronic billing, plus credentialing with insurers.

The role involves reviewing claims outstanding over 90 days, communicating with insurance companies about unpaid or denied claims, and ensuring accurate posting to patient accounts.

Qualifications

• High school diploma or equivalent.
• Experience working with medical claims, Insurance companies, patient accounts, insurance payment posting and charge posting.

Responsibilities

• Reviewing claims outstanding over 90 days.
• Researching within NextGen for reason claim not paid.
• Speak with insurance companies regarding unpaid or denied claims.
• If necessary, submit documentation to insurance companies
• Clear credit balances for patients and insurance companies.
• Backup: Charge Entry, Electronic Billing, Payment posting, Patient Accounts Clerk, Provider credentialing with insurance companies, Chota in-house credentialing for Providers.
• Complete annual trainings
• Review Policies and Procedures that pertain to job annually
• Participate in Patient Centered Medical Home Care Team collaboration.
• Performs other duties as assigned or requested.
• Participates in quality improvement activities.
• Regular and predictable attendance.
• Ability to cooperate and work well with others.
• Attend and participate in monthly staff meetings.

Skills

Medical claims knowledge

Insurance payment posting

Charge posting

Education

High school diploma or equivalent

Tools

NextGen

Job description

Chotahealth in Madisonville, TN is seeking an Insurance Claims Specialist to support follow-up on claims and denials, and to post insurance and patient payments. Responsibilities include charge entry and electronic billing, plus credentialing with insurers.

The role involves reviewing claims outstanding over 90 days, communicating with insurance companies about unpaid or denied claims, and ensuring accurate posting to patient accounts.