Collections & Denials Management Representative

Rochester Regional Health

4d•$21 - $30•Onsite

About The Position

A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims, and ensuring timely reimbursement for healthcare services. This role plays a critical part in the revenue cycle management of the healthcare organization by identifying trends in denials and taking corrective actions.

Requirements

None

Nice To Haves

High school graduate or equivalent
Bachelor’s degree in healthcare or business administration
Minimum 1 year medical billing and denials, customer service and relevant finance experience in a health care organization a plus
Certification in medical billing

Responsibilities

Submit and track insurance claims, resolve denials and billing edits, process remittances and adjustments, and ensure timely and accurate account resolution in line with payer requirements.
Conduct detailed reviews of denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to ensure successful claim outcomes.
Respond to patient inquiries, verify insurance eligibility and authorizations, and maintain thorough documentation while ensuring clear communication across Revenue Cycle teams.
Maintain HIPAA confidentiality, meet productivity benchmarks, stay current with billing policies, and manage workload with strong time management, organization, and communication skills.