Revenue Cycle Specialist: Denials & Appeals

Ohio State University Physicians; Columbus (OH); On-site; USD 25,000 - 37,000; Full time

Job summary

Ohio State University Physicians is seeking a Revenue Cycle Representative in Columbus, OH. The role focuses on processing and verifying invoices, ensuring claim payments, and reviewing reimbursements.

You will liaise between physicians, insurers and third parties to maintain smooth billing operations. Must have denials and appeals experience with strong communication and organizational skills; EPIC and imaging software experience is preferred.

Qualifications

• High School diploma or equivalent with two or more years of medical billing experience or equivalent.
• Knowledge of insurance carrier payment policies, practices and amounts.
• Strong organizational and problem-solving skills with ability to manage multiple priorities.
• Excellent written and verbal communication abilities.
• Ability to work under time pressures and interact with all levels of the organization.
• Experience with EPIC, Clearinghouse Vendors and imaging software is preferred.

Responsibilities

• Review and correct patient demographics, insurance information, diagnoses, and other data for billing.
• Provide problem resolution on payer denials and follow up as needed.
• Coordinate and analyze EOBs for denials and irregularities and reprocess claims.
• Investigate and resolve unpaid claims to maximize reimbursement.
• Resolve missing or conflicting patient information and request additional forms as needed.
• Update work queues and invoices for collection activity per guidelines.
• Reconcile accounts and adjust balances for denials and payments.
• Identify revenue trends and communicate issues to management; participate in solutions.
• Follow up on accounts receivable projects and report status to the manager.
• Maintain professionalism, punctuality, and cooperative interactions with staff and patients.

Skills

Denials and appeals experience

Insurance payment policies knowledge

Organizational skills

Effective communication

Time management

Education

High School diploma or equivalent with two+ years medical billing experience

Tools

EPIC

Clearinghouse Vendors

Imaging software systems

Job description

Ohio State University Physicians is seeking a Revenue Cycle Representative in Columbus, OH. The role focuses on processing and verifying invoices, ensuring claim payments, and reviewing reimbursements.

You will liaise between physicians, insurers and third parties to maintain smooth billing operations. Must have denials and appeals experience with strong communication and organizational skills; EPIC and imaging software experience is preferred.