Medical Billing Specialist (Denials)

Citrus Cardiology Consultants, P.L.L.C.; Inverness (FL); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

Health Savings Account (HSA)

Life insurance

Paid Time Off (PTO)

Supplemental plan

Job summary

Citrus Cardiology Consultants, P.L.L.C. is seeking a detail-oriented denial specialist to investigate, resolve, and appeal denied medical insurance claims. This role focuses on maximizing revenue by ensuring accurate coding, documentation, and timely follow-up with insurers.

Responsibilities include auditing charts, interpreting EOBs, and maintaining precise records. Proficiency in Excel and EMR systems, with eCW preferred, is essential for success in a fast-paced office environment.

Qualifications

• High school diploma or GED required.
• Two years of medical denial experience required.
• Experience accessing insurance portals.
• Proficient in Microsoft Excel and EMR systems, eCW preferred.
• Strong analytical and communication skills with exceptional attention to detail.

Responsibilities

• Process denied claims and follow up with insurance companies to resolve discrepancies or reimbursement issues.
• Audit patient charts to confirm proper coding and documentation for billing accuracy.
• Read, analyze, and interpret Explanation of Benefits (EOBs) to determine next steps for claim resolution.
• Ensure all denials are submitted with complete and accurate information.
• Ensure that denials are worked on daily and assist with tasks as assigned.
• Process electronic and paper payment postings efficiently and accurately.
• Communicate regularly with administrative and clinical staff, preparing detailed reports for administration as needed.

Skills

Analytical skills

Communication skills

Excel

Education

High school diploma or GED

Two years medical denial experience

Tools

EMR (eCW)

Job description

This position is responsible for investigating, resolving, and appealing denied medical insurance claims to maximize revenue and minimize outstanding accounts receivable. This role requires a strong understanding of insurance guidelines, billing codes, and medical documentation standards.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Process denied claims and follow up with insurance companies to resolve discrepancies or reimbursement issues.
• Audit patient charts to confirm proper coding and documentation for billing accuracy.
• Read, analyze, and interpret Explanation of Benefits (EOBs) to determine next steps for claim resolution.
• Ensure all denials are submitted with complete and accurate information.
• Ensure that denials are worked on daily and assist with tasks as assigned.
• Process electronic and paper payment postings efficiently and accurately.
• Communicate regularly with administrative and clinical staff, preparing detailed reports for administration as needed.

EDUCATION AND/OR EXPERIENCE

• High school diploma or GED required
• Two years of medical denial experience required
• Previous experience accessing insurance portals
• Proficient in Microsoft Excel and EMR systems, eCW preferred
• Strong analytical and communication skills with exceptional attention to detail

Why Join Us?

Benefits Include:

• Medical insurance
• Vision insurance
• Health Savings Account (HSA)
• Life insurance
• Paid Time Off (PTO)
• Additional supplemental plan available as well!