Physician Billing Specialist II: Denial Resolution & Reimbursement

Christiana Care Health System; Wilmington (DE); On-site; USD 31,000 - 47,000; Full time

Job summary

Christiana Care Health System seeks a Denials Specialist to review, analyze and initiate action for denial resolution by communicating with payers, practices, departments and patients for data as assigned. Focus on specialty payers and timely follow-up with insurers.

The role involves rebilling, authorization research, balance write-offs or transfers, ensuring proper CPT4/ICD10 coding and accurate billing information, and meeting productivity standards in a hospital setting.

Qualifications

• 3–5 years of physician billing/coding experience, preferably in a computerized physician billing department or large physician group practice.
• Epic experience preferred.
• Prior experience with and understanding CARC/RARC codes.

Responsibilities

• Review denial and no-response work queues to resolve uncollected balances.
• Perform authorization research, rebilling, balance write-offs or transfers as needed.
• Follow up with insurance carriers to obtain payment status and resolve claims.
• Ensure CPT4/ICD10 coding accuracy and complete billing information.
• Meet departmental productivity benchmarks.
• Submit required documentation to payers to secure payment.
• Verifiy and correct coverage changes and update registration information when needed.

Education

High school diploma or equivalent

Associate's degree preferred

Tools

Epic

Job description

Christiana Care Health System seeks a Denials Specialist to review, analyze and initiate action for denial resolution by communicating with payers, practices, departments and patients for data as assigned. Focus on specialty payers and timely follow-up with insurers.

The role involves rebilling, authorization research, balance write-offs or transfers, ensuring proper CPT4/ICD10 coding and accurate billing information, and meeting productivity standards in a hospital setting.