Denials Account Specialist II

TriHealth•Norwood, OH

6d•Onsite

About The Position

Join TriHealth as a Denials Specialist II and bring your expertise to a mission-driven health system that values accuracy, integrity, and teamwork. In this role, you’ll help protect the financial health of the organization by resolving payer issues, interpreting EOBs, and ensuring claims are processed correctly. We’re looking for someone with strong revenue cycle experience - ideally in hospital billing - who thrives on problem-solving and investigating discrepancies to drive accurate outcomes. This position's principal purpose is to expedite positive cash flow, maximize reimbursement, and reduce/eliminate financial loss to department customers by efficient billing, follow-up and collections of patient accounts. Duties include: Submit charge information into appropriate system; Post payments; Follow-up on patient account balances including insurance/patient financial balances; Process the specified number of accounts on a daily basis based on customer specialty and unique billing requirements; Contact payers regarding payment; Resolve incorrect payment issues and ensure balances after insurance payments are correct, including entry of corrections into systems; Reconcile monthly reports; Demonstrate quality customer service to internal/external customers.

Requirements

High School Diploma or GED Degree (Required)
3 - 4 years’ experience in a related field (Required)
Specialized knowledge in Medicaid/Medicare billing, and other payer sources

Nice To Haves

Strong revenue cycle experience - ideally in hospital billing
Thrives on problem-solving and investigating discrepancies to drive accurate outcomes

Responsibilities

Bills and collects dollars outstanding through interaction with payer and participates willing in payer communication.
Actively protects the financial resource of Bethesda Healthcare, Inc.
Completes assigned workload based on predefined key performance indicator on a daily basis ensuring accuracy.
Show an effort to consistently produce quality work.
Demonstrates proper customer service skills toward internal and external customers through prompt and courteous communications.
Participate in monthly billing meetings with customer contacts.
Prepares status report and submits agenda items to manager one business day prior to meeting.
Through cross training and experience, develops and maintains comprehensive knowledge and understanding of billing and follow-up procedures for all BWC and non-BWC payers.
Works with minimal supervisory oversight and exercised appropriate judgment in identifying instances which require management intervention.
Identifies and appropriately communicates process improvement with Manager in a timely manner.
Submit charge information into appropriate system
Post payments
Follow-up on patient account balances including insurance/patient financial balances
Process the specified number of accounts on a daily basis based on customer specialty and unique billing requirements
Contact payers regarding payment
Resolve incorrect payment issues and ensure balances after insurance payments are correct, including entry of corrections into systems
Reconcile monthly reports
Demonstrate quality customer service to internal/external customers