Patient Billing & Insurance Claims Specialist

Frederick Health; Frederick (MD); On-site; USD 25,000 - 36,000; Full time

Benefits offered by this job

Health, Dental and Vision insurance (1

Job summary

Frederick Health is seeking a Patient Financial Service Representative to ensure accurate patient charges and payments, obtain insurance authorization, and timely submission to obtain payment from third-party payers or patients.

The role emphasizes accuracy given payer requirements and the need to prioritize work to maximize efficiency. The position handles communications with payers, reviews denials, and supports continuous process improvement within the Revenue Cycle.

Qualifications

• Strong analytics, communication and organization skills and 40 wpm typing speed are required.

Responsibilities

• Examines denied and underpaid claims to determine reasons for discrepancies.
• Communicates directly with payers to follow up on outstanding claims, resolve payment variances, and achieve timely reimbursement.
• Provides payers with specific reasons for suspected underpayments and analyzes denial reasons given by payers.
• Works with management to identify, trend, and address root causes of denials; helps pinpoint strategies for reducing A/R.
• Maintains a thorough understanding of federal and state regulations, as well as payer requirements, to identify and report billing issues.
• Updates and maintains accurate files on each payer; documents all interactions with payers.
• Effectively handles communications from payers and departments within the business office.
• Utilizes payer scorecards, identifies high-risk accounts, and prioritizes follow-up efforts.
• Demonstrates initiative and communicates trends to management; adheres to HIPAA guidelines.
• Receives and processes all types of patient payments and posts transactions promptly.
• Prepares, posts, and processes payment batches; ensures batches are balanced.

Skills

Analytics

Communication

Organization

Typing 40 wpm

Education

High School diploma or GED

Job description

Frederick Health is seeking a Patient Financial Service Representative to ensure accurate patient charges and payments, obtain insurance authorization, and timely submission to obtain payment from third-party payers or patients.

The role emphasizes accuracy given payer requirements and the need to prioritize work to maximize efficiency. The position handles communications with payers, reviews denials, and supports continuous process improvement within the Revenue Cycle.