Physician Billing Denials Specialist II

Christiana Care Health Services, Inc.; United States; On-site; USD 32,000 - 47,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Retirement

Employee assistance program

Job summary

Christiana Care Health System seeks a denials specialist to review, analyze, and act on payer denials. You will communicate with payers, medical practices, hospital departments, and patients to gather data and drive resolution of unpaid balances.

Responsibilities include researching authorizations, rebilling, write-offs or transfers, following up with insurance carriers, and ensuring accurate CPT4/ICD10 coding.

Qualifications

• Thorough understanding of revenue cycle processes from patient access to billing and collections.
• Knowledge of medical terminology and physician billing policies.
• Familiarity with CPT4 and ICD10 coding in physician billing.

Responsibilities

• Review denial/work queues to resolve uncollected balances.
• Research authorizations, rebilling, and balance write-off or transfer of charges.
• Escalate issues as appropriate and follow-up with payers.
• Follow up with insurance carriers to obtain payment status and resolve claims.
• Review coverage changes and rebill charges as needed.
• Assign payer plans and update registration information.
• Ensure CPT4/ICD10 coding accuracy in encounters and claims.
• Ensure claims have complete billing information.
• Meet productivity benchmarks.
• Submit required documents to third-party payers for payment.
• Review payment vouchers for proper reimbursement.
• Resolve patient insurance discrepancies with office staff.
• Submit claims timely to insurers.
• Adhere to safety rules and report hazards.
• Perform related duties as required.

Skills

Revenue cycle knowledge

Medical terminology

CPT4/ICD10 coding

Physician billing

Written communication

Independence

Judgement and tact

Education

High school diploma or equivalent

Associate degree preferred

Tools

Epic experience

Job description

Christiana Care Health System seeks a denials specialist to review, analyze, and act on payer denials. You will communicate with payers, medical practices, hospital departments, and patients to gather data and drive resolution of unpaid balances.

Responsibilities include researching authorizations, rebilling, write-offs or transfers, following up with insurance carriers, and ensuring accurate CPT4/ICD10 coding.