Revenue Cycle Specialist II - Denials & Claims Expert

Northeast Georgia Medical Center; Gainesville (GA); On-site; USD 60,000 - 75,000; Full time

Job summary

Northeast Georgia Health System is seeking a Rev Cycle Specialist II to handle complex account follow-up, denials, and claims resolution with increasing independence and advanced knowledge of payer rules and billing systems.

Candidates should have GA CPAR certification (or obtain within 6 months), a HS Diploma or GED, and at least 3 years of hospital or professional billing experience; strong problem-solving and customer service are essential.

Qualifications

• High School Diploma or GED required.
• 3+ years hospital or professional billing/collections experience.

Responsibilities

• Review, resubmit, and follow up on complex insurance claims.
• Perform detailed account research and update account information accurately.
• Resolve denials and ensure adherence to payer contract requirements.
• Maintain work queues and ensure timely resolution of accounts.
• Provide support to teammates and cross-train in additional revenue cycle functions.
• Demonstrate strong documentation, analytics, professionalism, and customer service.

Skills

Payer policies

Account follow-up

Denials resolution

Billing systems

Customer service

Education

High School Diploma or GED

Tools

Billing systems

Patient accounting systems

Job description

Northeast Georgia Health System is seeking a Rev Cycle Specialist II to handle complex account follow-up, denials, and claims resolution with increasing independence and advanced knowledge of payer rules and billing systems.

Candidates should have GA CPAR certification (or obtain within 6 months), a HS Diploma or GED, and at least 3 years of hospital or professional billing experience; strong problem-solving and customer service are essential.