Medical Billing & Denials Specialist

Rochester Regional Health • Canton, NY • 1w ago

Description Job Title: Medical Billing & Denials SpecialistDepartment: Patient Financial ServicesLocation: Massena HospitalHours Per Week: 40Schedule: Monday - Friday 8AM-4PMSUMMARY: 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.RESPONSIBILITIES:Medical Billing Expertise: 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.Claims and Appeals Processing: Submits and follows up on insurance claims; resolves denials and rejections; prepares appeal letters with proper documentation and cross-department coordination.Account Management & Collections: Retrieves and updates patient account statuses, processes remittances, manages A/R, ensures accurate charge entry, and performs financial analysis to support revenue goals.Communication & Customer Service: Answers patient and payer inquiries, verifies insurance eligibility and authorizations, documents account activity, and maintains confidentiality in compliance with HIPAA.Operational Efficiency: Utilizes EMR systems, adheres to productivity benchmarks, meets deadlines, and demonstrates strong organizational, multitasking, and communication skills.PREFERRED QUALIFICATIONS:Bachelor's degree in healthcare or business administrationExperience in medical billing and denials, customer service and relevant finance experience in a health care organization a plus Certification in medical billing PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.PAY RANGE: $20.18 - $27.29 The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, clinical licensure date, relevant qualifications, specialty, internal equity, location, and contracts. Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.Apply here: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjM2MDMxLjEwNDE3QHJvY2hlc3RlcnJlZ2lvbmFsY29tcC5hcGxpdHJhay5jb20

Similar Jobs

Nursing Supervisor- Per Diem

Rochester Regional Health • Potsdam, NY • 1d ago

Hospital & Medical

Description Job Title: Nursing SupervisorDepartment: Med/SurgLocation: Canton-Potsdam HospitalHours Per Week: Per DiemSchedule: 12-hour variable shiftsSUMMARY: The Nurse Supervisor is a nursing leader who serves as a res...

1d ago

Go to Apply

Registered Nurse - Per Diem Pool II - Obstetrics

Rochester Regional Health • Potsdam, NY • 4d ago

Hospital & Medical

Description Job Title: Registered Nurse - Per Diem Pool IIDepartment: ObstetricsLocation: Canton-Potsdam HospitalHours Per Week: Per DiemSchedule: 12-hour variable shiftsSUMMARY: The registered nurse provides assessment,...

4d ago

Go to Apply

CHMC - Medical Assistant

Claxton-Hepburn Medical Center • Ogdensburg, NY • 6d ago

Hospital & Medical

CHMC - Dermatology/Plastics Clinic- Medical Assistant - Full Time- Day Shift -Req 9123 Pay Range: $17.45-$22.25 (uncertified)* $18.51-$23.60 (certified)* Job Summary: The Medical Assistant will be part of the team concep...

6d ago

Go to Apply

Rochester Regional Health • Potsdam, NY • 2w ago

Hospital & Medical

Description Job Title: Physical Therapist - Per DiemDepartment: CPH Physical TherapyLocation: 49 Lawrence Ave. Potsdam, NY 13676* Must be ok with traveling to other locationsHours Per Week: Per DiemSchedule: 4 to 7.5 shi...

2w ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.