Medical Billing & Denials Specialist

Rochester Regional Health

1d • $20 - $29 • Onsite

About The Position

The Medical Billing & Denials Specialist ensures that all patient/insurance information, charges, billings and follow-up on patient accounts is accurate, complete, and timely. Prepares and submits claims to various insurance companies through appropriate channels. Responsible to retrieve status information from payer websites and update patient account information as needed to ensure denials are worked thoroughly for timely reimbursement. Responsible for reviewing accounts which have been denied or underpaid by third party payers; the specialist will work across departments to gather the appropriate documentation and information for a clear and concise appeal. Understand medical billing/denials guidelines, and medical terminology.

Requirements

• Understand medical billing/denials guidelines, and medical terminology.

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.

Benefits

• Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials. It’s vision is to lead the evolution of healthcare to enable every member of the communities it serves to enjoy a better, healthier life.

What This Job Offers

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