About this role
Overview
Responsible for timely billing and follow-up of claims for assigned areas. Reviews claims for accuracy for submission and follows up on claims for timely payment. Researches and writes appeals on denied accounts and works aging reports.
What you will do
- Ensures all claims are reviewed for accuracy prior to submission to all payers.
- Completes claim work queues.
- Follows up on claims for timely payment. Submits electronic adjustments as needed and resubmits applicable insurance claims within department guidelines.
- Process very detailed appeals for denials, including the ability to work directly with respective departments and staff to obtain additional documentation to support the appeal.
- Manages assigned portion of AR. Collaborates with the billing office team to resolve outstanding account balances.
- Responds to insurance company requests and processes all insurance/patient correspondence within department guidelines.
- Resolves patient inquiries and complaints and assists patients with COB corrections.
- Acts as a liaison between the billing office and all front-end locations and insurance payers providing consistent detailed information on issues and trends
Qualifications
Education
- High School Diploma or GED, (Required)
- Bachelors Degree, Accounting, Finance or related field (will count for one year of experience) (Preferred)
Experience
- 2 years Revenue Cycle experience (Required)
- 1 year Medical Billing for specific area (Preferred)
Skills and Abilities
- Ability to be professional, while assertive, with payers
To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.
Other facts
About Riverside Health System
Riverside Health is a non-profit, integrated network of hospitals, physicians, continuing care facilities, wellness centers, etc. providing comprehensive, high quality health care services to citizens of eastern Virginia. Riverside has been the leading provider of state-of-the-art healthcare in the region since 1915.
All information shared on this social media platform is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care providers with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have heard or read.
What you'll do
- The specialist is responsible for timely billing and follow-up of claims, ensuring accuracy prior to submission and managing aging reports. They will also research and write appeals for denied accounts and collaborate with the billing office team to resolve outstanding balances.
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