Medical Billing & Denials Specialist

Rochester Regional Health

6d • $20 - $29 • Onsite

About The Position

The Medical Billing & Denials Specialist ensures patient and insurance information, charges, billings, and account follow-up are accurate, complete, and timely. The specialist prepares and submits claims to insurance companies through appropriate channels, retrieves status information from payer websites, and updates patient accounts to ensure denials are thoroughly addressed and reimbursement is timely. The role reviews accounts denied or underpaid by third-party payers and works across departments to obtain documentation and information for clear, concise appeals. The specialist must understand medical billing and denials guidelines and medical terminology.

This position is in Patient Financial Services at 6196 U.S. 11, Canton, NY 13617. The schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m., for 40 hours per week.

Requirements

• High school graduation or equivalent.
• Minimum of 1 year of experience in medical billing and denials, customer service, and relevant finance experience in a healthcare organization is listed as a preferred qualification.

Nice To Haves

• Bachelor’s degree in healthcare or business administration.
• Certification in medical billing.
• At least 1 year of medical billing and denials, customer service, and relevant finance experience in a healthcare organization.

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.
• Review denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to support successful claim outcomes.
• Respond to patient inquiries, verify insurance eligibility and authorizations, and maintain thorough documentation and 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.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED