Insurance & Billing - Denials Specialist

Whitewater Eye Centers•Richmond, VA

6d•Onsite

About The Position

The Denials Specialist will report to the I & B Manager and will focus on promoting Whitewater Eye Centers financial health and following the billing cycle for all locations to maximize cash flow. The Denials Specialist will work closely with insurance payers to go over account receivables, work denials, billing, payment posting, understands policy and guideline changes, recoupment payments, correspondence letters and going over patient balances. This position will primarily focus on insurance denials.

Requirements

Three years of medical billing & coding experience; at least two years processing medical denials.
Experience in EHR billing system; NexTech preferred
Strong organizational skills and attention to detail.
Computer literacy, including knowledge of software programs utilized in the practice.
Bookkeeping skills with a working knowledge of medical billing software.
Knowledge of insurance rules and regulations, including Medicare/Medicaid
Knowledge of CPT and ICD-10 coding.
Good communication skills.
Ability to work as a team member.
Management of multiple projects simultaneously.
Respectful treatment of patients and co-workers.

Nice To Haves

Additional certifications related to medical billing and coding preferred.

Responsibilities

Prioritize and review denied insurance claims and resolve billing specified to unpaid claims
Communicate with management to resolve billing disputes and escalations
Review code change requests to determine accurate coding and/or advise coding or billing changes to ensure appropriate reimbursement
Contact carriers and patients to maximize reimbursement on accounts to be worked
Serve as a point of contact for billing problem solving
Respond to correspondence inquiries by phone, mail for resolution
Respond to inquiries from staff members regarding patient charges, coding and eligibility
Maintain high level of patient confidentiality to ensure compliance with HIPAA regulations
Responsible for managing daily billing functions for assigned insurance payer
Responsible for submitting accurate coding and billing procedures to obtain appropriate reimbursement for commercial, government, third party payers, and other network entities
Post payments and balance unapplied payments from carrier remits, self-pay