PFS Billing Specialist: Insurance Claims & Denials Expert

Appone; Bluffton (SC); On-site; USD 36,000 - 48,000; Full time

Job summary

Beaufort Memorial Hospital in Bluffton is seeking a Hospital Billing Representative to join the Patient Financial Services team. This role focuses on following up insurance claims, resolving payment issues, and supporting revenue cycle performance while maintaining patient confidentiality.

You should have a high school diploma and experience with insurance claims follow-up and denial management, plus knowledge of Medicare, Medicaid, and commercial payers.

Qualifications

• High school diploma or equivalent.
• Experience with insurance claims follow-up and denial management.
• Working knowledge of Medicare, Medicaid, and commercial payers.
• Ability to manage accounts receivable and interpret aging reports.

Responsibilities

• Follow up on outstanding insurance claims to ensure timely reimbursement.
• Contact insurance companies to verify claim status and resolve payment issues.
• Review denied claims and identify root causes of denials.
• Prepare and submit appeals with complete and accurate documentation.
• Document all follow-up actions clearly within the billing system.
• Collaborate with coding and billing teams to correct claim errors.
• Monitor aging reports and prioritize high-value or time-sensitive accounts.
• Ensure compliance with HIPAA regulations and payer guidelines.
• Support continuous improvement initiatives within the revenue cycle department.
• Perform other duties as assigned within the Patient Financial Services team.

Skills

Insurance claims follow-up

Denial management

Accounts receivable management

Aging reports interpretation

Education

High school diploma

Job description

Beaufort Memorial Hospital in Bluffton is seeking a Hospital Billing Representative to join the Patient Financial Services team. This role focuses on following up insurance claims, resolving payment issues, and supporting revenue cycle performance while maintaining patient confidentiality.

You should have a high school diploma and experience with insurance claims follow-up and denial management, plus knowledge of Medicare, Medicaid, and commercial payers.