Revenue Cycle Claims Specialist

Yale New Haven Health; Trumbull (CT); Vor Ort; USD 45.000 - 60.000; Vollzeit

Zusammenfassung

Yale NewHaven Health is seeking a Billing/Claims professional to manage high volumes of third party claims and ensure accurate payer submissions. This role emphasizes timely billing, effective follow-up on denials, and knowledge of payer rules within a busy hospital revenue cycle.

Experience with Epic and strong analytical skills are highly valued. The position involves coordinating with multiple hospital departments to optimize payments and maintain compliant billing practices.

Qualifikationen

• 1–2 years of third party claims management and/or billing in a computerized hospital/healthcare revenue cycle environment (Epic preferred).
• Knowledge of third party insurance carriers and their billing and reimbursement requirements.
• Excellent analytical and organizational skills.
• Ability to communicate effectively both written and verbally.
• Microsoft Office proficiency.
• Proven ability to navigate payer websites and other web-based applications.

Aufgaben

• Handle a high volume of third party claims and ensure accurate information is submitted to payers via clearing house or payer intermediary.
• Complete daily claims submission within the timeframe designated by supervisor and resubmit with updates as needed.
• Follow up on paid and unpaid claims to expedite prompt payment; identify reasons for nonpayment and take appropriate action.
• Post adjustments and resolve inpatient/outpatient credit balances as required by department procedures.
• Keep abreast of changes to federal, state, and insurance regulations and apply them to billing practices.

Kenntnisse

Insurance knowledge

Analytical skills

Organizational skills

Written and verbal communication

Microsoft Office

Payer websites/web apps

Ausbildung

High school diploma

Associate degree in business

Tools

Epic

Jobbeschreibung

Yale NewHaven Health is seeking a Billing/Claims professional to manage high volumes of third party claims and ensure accurate payer submissions. This role emphasizes timely billing, effective follow-up on denials, and knowledge of payer rules within a busy hospital revenue cycle.

Experience with Epic and strong analytical skills are highly valued. The position involves coordinating with multiple hospital departments to optimize payments and maintain compliant billing practices.