Occupational Health Billing Specialist - Growth & Impact

Bayview Physicians Group; Virginia Beach (VA); On-site; USD 20,664 - 37,195; Full time

Benefits offered by this job

Full-time benefits

Supportive team culture

Multiple locations

Career advancement

Job summary

Bayview Physicians Group in Virginia Beach is seeking an experienced medical claims reviewer to ensure correct payments under payer contracts and align with regulatory requirements. The role involves reviewing occupational health claims, reprocessing unprocessed claims within filing limits, verifying EOBs, and maintaining productive payer relationships.

Excellent accuracy, confidentiality, and timely follow-up are essential as part of a collaborative, full-time team.

Qualifications

• High school graduate or equivalent.
• Minimum of 1 year of previous medical experience required.

Responsibilities

• Reviewing and addressing occupational health claims to ensure proper payments according to the payer's contract.
• Reviewing unprocessed claims within the payer's timely filing limits for resubmission of claims for payment.
• Researching Eligibility of Benefits (EOB) to verify correct payment and adjustments posted to patient accounts.
• Researching EOBs to determine if unpaid balances need to be appealed to the Worker’s Compensation Committee.
• Researching denied claims or claims with no response to determine proper follow-up steps to obtain payment.
• Posting occupational health and workers' compensation payments.
• Answer client inquiries via phone and email daily.

Education

High school diploma or equivalent

Minimum of 1 year of previous medical experience

Job description

Bayview Physicians Group in Virginia Beach is seeking an experienced medical claims reviewer to ensure correct payments under payer contracts and align with regulatory requirements. The role involves reviewing occupational health claims, reprocessing unprocessed claims within filing limits, verifying EOBs, and maintaining productive payer relationships.

Excellent accuracy, confidentiality, and timely follow-up are essential as part of a collaborative, full-time team.