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Prepare and submit patient claims accurately, making corrections as needed before transmission to insurance carriers and other payers
Investigate unpaid, denied, or overdue balances, take appropriate follow-up steps, and pursue resolution to improve collections outcomes
Communicate with patients, insurance representatives, government programs, and third-party payers to obtain information needed for reimbursement and account completion
Apply payments to the proper accounts and process write-offs, credits, debits, and contractual adjustments with a high level of accuracy
Review explanation of benefits and denial details to determine next actions, including account correction, follow-up, or adjustment posting
Maintain expected productivity and quality standards while managing assigned account volume and documentation requirements
Support billing workflows involving workers’ compensation and other specialty payers when applicable
Use healthcare systems and billing applications such as Cerner and related reimbursement tools to manage account activity and follow-up
Carry out additional patient account and revenue cycle duties as assigned to support departmental operations
Requirements
High school diploma or equivalent preferred
additional college or technical training is a plus
Prior experience in healthcare billing, account follow-up, or medical collections preferred
Working knowledge of claim processing, denial review, reimbursement practices, and account adjustment procedures
Ability to read payer responses and explanation of benefits documents and determine appropriate corrective action
Familiarity with payment posting, credit and debit adjustments, and insurance or patient account reconciliation
Experience working with workers’ compensation claims and government or commercial payers is advantageous
Proficiency with electronic billing platforms or hospital systems such as Cerner is preferred
Ability to meet vaccination requirements and employment eligibility verification standards, including E-Verify participation where applicable
Nice to have
Additional college or technical training
Experience with workers’ compensation claims and government or commercial payers
Proficiency with Cerner
What we offer
Medical, vision, dental, and life and disability insurance