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Medical Insurance Billing Specialist

1 month ago

Athens, Georgia, United States Georgia Department of Public Health Full time
Job Title: Medical Insurance Billing Specialist

We are seeking a highly skilled Medical Insurance Billing Specialist to join our team at the Georgia Department of Public Health. As a Medical Insurance Billing Specialist, you will be responsible for assisting with the billing process, researching payer denials, and submitting appeals to payers.

Key Responsibilities:

  • Research payer denials related to referral, pre-authorization, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment.
  • Independently write professional appeal letters.
  • Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines.
  • Identify denial patterns and escalate to supervisor as appropriate with sufficient information for additional follow-up, and/or root cause resolution.
  • Make recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency and reduce denials.
  • Review payor communications, identifying risk for loss reimbursement related to medical policies and prior authorization requirements.
  • Identify opportunities for process improvement and actively participate in process improvement initiatives.
  • Review self-pay encounters for errors when billing should have occurred.
  • Assist with insurance verification.
  • Serve as backup to billing team members.

Requirements:

  • High school diploma/GED and one (1) year of job-related experience in accounting, billing, or budget services.
  • Medical billing experience, working with denials for Medicaid, Medicare and/or third-party payers. Medical Coding Certification (CPC).

Benefits:

  • Annual salary $36,000 plus generous benefits package including 13 paid holidays, annual and sick leave, health insurance, and retirement plans.

How to Apply:

Applications accepted ONLINE ONLY through the link posted.