Job Summary
This position is focused on reviewing and analyzing denied insurance claims, collecting relevant documentation, and submitting appeals in accordance with payer and regulatory timelines. The role involves collaboration with various stakeholders including billing and coding teams, providers, patients, and insurers to facilitate smooth operations within the claims process.
Responsibilities
- Investigate and review denied insurance claims.
- Gather necessary records and documentation to support appeals.
- Prepare and submit appeals within designated deadlines.
- Coordinate with billing, coding, authorization, providers, and patients.
- Assist with payment posting and resolution of account errors.
- Conduct insurance verifications and manage incoming inquiries as required.
Qualifications
- A high school diploma is preferred.
- Proficiency in computer and/or secretarial skills.
- At least one year of clerical experience, with a minimum of three months in progressively responsible roles.
- Strong analytical and organizational abilities.
- Efficient communication skills and proficiency in English.
- Ability to work independently and maintain regular attendance.
- Capability to perform tasks in an office environment, which may include prolonged sitting and handling of paperwork.
Jamestown Regional Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
