Medical Billing Representative

Rochester Regional Health

3d•$20 - $29•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

Medical Billing Expertise
Claims and Appeals Processing
Account Management & Collections
Communication & Customer Service
Operational Efficiency
HIPAA compliance

Nice To Haves

Bachelor’s degree in healthcare or business administration
Experience in medical billing and denials, customer service and relevant finance experience in a health care organization a plus
Certification in medical billing

Responsibilities

Proficient in billing, claims processing (Inpatient, Outpatient, Critical Access, Rural Health), denials management, and knowledge of medical terminology, physician fee schedules, DRGs, and reimbursement procedures.
Submits and follows up on insurance claims; resolves denials and rejections; prepares appeal letters with proper documentation and cross-department coordination.
Retrieves and updates patient account statuses, processes remittances, manages A/R, ensures accurate charge entry, and performs financial analysis to support revenue goals.
Answers patient and payer inquiries, verifies insurance eligibility and authorizations, documents account activity, and maintains confidentiality in compliance with HIPAA.
Utilizes EMR systems, adheres to productivity benchmarks, meets deadlines, and demonstrates strong organizational, multitasking, and communication skills.