Patient Billing & Denials Specialist

Advocate Health Care; Laurinburg (NC); On-site; USD 42,000 - 64,000; Full time

Job summary

Scotland Health Care System in Laurinburg, NC seeks a dedicated Revenue Cycle Specialist to examine denied and underpaid claims, explain the discrepancies to payers, and support strategies to reduce accounts receivable. You will maintain payer files, document interactions, and ensure HIPAA compliance as part of a collaborative team.

The role emphasizes accuracy, process improvement, and clear communication with departments and payers, with opportunities to participate in ongoing training and

Qualifications

• Examine denied and underpaid claims and identify reasons for discrepancies.
• Provide payers with specific reasons for suspected underpayments and analyze payer denial reasons.
• Work with management to identify trends and address root causes of denials.
• Maintain knowledge of regulations and payer requirements to report billing compliance issues.
• Update and maintain payer files with contact names, addresses, phone numbers, websites and other pertinent information; thoroughly document all interactions with payers.
• Handle communications from payers and internal departments via phone and email.
• Participate in continuous quality improvement efforts and track progress with management.
• Demonstrate initiative by communicating trends and issues to management.
• Cross-trained in other areas within Patient Accounts.
• Begin HBI Revenue Cycle classes.
• Understand and maintain HIPAA compliance when handling patient information.
• Performs other duties as assigned.

Responsibilities

• Examine denied and underpaid claims and determine discrepancy reasons.
• Communicate with payers and internal departments to resolve issues.
• Identify and report trends to management for AR reduction.

Job description

Scotland Health Care System in Laurinburg, NC seeks a dedicated Revenue Cycle Specialist to examine denied and underpaid claims, explain the discrepancies to payers, and support strategies to reduce accounts receivable. You will maintain payer files, document interactions, and ensure HIPAA compliance as part of a collaborative team.

The role emphasizes accuracy, process improvement, and clear communication with departments and payers, with opportunities to participate in ongoing training and