Medical Billing Specialist: Denials & Claims Expert

Saint Peter’s Healthcare System; Piscataway Township (NJ); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) match

Adoption assistance

Free onsite parking

Back-up daycare

Job summary

Saint Peter’s Healthcare System is seeking a Billing Services Representative to ensure account accuracy and review daily claims for timeliness. The role involves monitoring charges, CPT-4/HCPCS coding, and denials; collaborating with payors and departments to resolve issues; and processing adjustments and patient transfers.

The position requires experience in medical billing, proficiency with Word/Excel, and strong interpersonal skills to lead patient accounts activities while adhering to HIPAA

Qualifications

• 1+ year experience in medical billing or hospital billing preferred.
• Proficient in Word and Excel.
• Strong interpersonal skills to lead and work with Patient Accounts staff.
• Knowledge of collection, A/R follow-up and billing processes.
• Familiarity with third-party payers and federal/state agencies.

Responsibilities

• Ensure account accuracy and review daily claims for timeliness.
• Monitor charges, modifiers, CPT-4s/HCPCS, payments, DRGs, ICD-10 coding.
• Review outstanding accounts using various reports.
• Submit adjustments, notes, patient balance transfers, and record requests.
• Work with management to address payor/department issues.
• Resolve issues and problems independently when possible.
• Utilize hospital information system and billing systems.
• Manage denials and appeals of administrative claims.
• Understand denials and proper handling.

Skills

Microsoft Word

Microsoft Excel

Interpersonal skills

Attention to detail

Deadline management

Tools

Hospital information system

Electronic billing system

Contract management system

Payer portals

Job description

Saint Peter’s Healthcare System is seeking a Billing Services Representative to ensure account accuracy and review daily claims for timeliness. The role involves monitoring charges, CPT-4/HCPCS coding, and denials; collaborating with payors and departments to resolve issues; and processing adjustments and patient transfers.

The position requires experience in medical billing, proficiency with Word/Excel, and strong interpersonal skills to lead patient accounts activities while adhering to HIPAA