Medical Billing and Denials Specialist

Rochester Regional Health

11d • $21 - $30

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.

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

• Medical Billing & Claims Management: 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.
• Appeals & Reimbursement Review: Conduct detailed reviews of denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to ensure successful claim outcomes.
• Customer Service & Communication: Respond to patient inquiries, verify insurance eligibility and authorizations, and maintain thorough documentation while ensuring clear communication across Revenue Cycle teams.
• Compliance & Operational Excellence: Maintain HIPAA confidentiality, meet productivity benchmarks, stay current with billing policies, and manage workload with strong time management, organization, and communication skills.

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees