Patient Billing - Claims & Denials Specialist

Tfhd; Truckee, Northern (CA, KY); Hybrid; USD 52,000 - 76,000; Full time

Job summary

Tfhd is seeking a billing professional responsible for submitting accurate claims and ensuring timely reimbursement from payers and patients. The role requires collaboration with Revenue Cycle teams and strong follow-up on denials and appeals.

The ideal candidate will review denied claims, communicate with payers, document payment statuses, and help reduce accounts receivable while staying compliant with HIPAA and payer requirements.

Qualifications

• No educational requirement.
• 2–3 years relevant experience in hospital and/or physician billing.
• Medicare or Medi-Cal (Medicaid) billing experience preferred.
• EPIC Hospital Billing and/or Physician Billing experience preferred.
• HIPAA compliance awareness.

Responsibilities

• Examines denied and underpaid claims to determine reasons for discrepancies.
• Communicates with payers via phone and web portals to follow up on outstanding claims and achieve timely reimbursement.
• Documents payer interactions and tracks status and expected payment amounts.
• Identifies root causes of denials and helps develop strategies to reduce accounts receivable.
• Keeps payer information current and notifies relevant departments of changes.
• Participates in quality improvement efforts and supports system fixes as needed.

Job description

Tfhd is seeking a billing professional responsible for submitting accurate claims and ensuring timely reimbursement from payers and patients. The role requires collaboration with Revenue Cycle teams and strong follow-up on denials and appeals.

The ideal candidate will review denied claims, communicate with payers, document payment statuses, and help reduce accounts receivable while staying compliant with HIPAA and payer requirements.