Billing Denials Representative

Located at our Core Lab (Moraine, OH)/Remote Shift Availability 

Full-Time Day Shift

Position Summary:

Under the supervision of the Billing Department Manager: perform the daily account processing tasks of the Billing Department including billing data entry, third party billing and follow up; review denials and resubmit claims; answer incoming as well as place outgoing calls to both patients and clients while maintaining positive internal and external working relationships with patients, clients and third party payers.

Responsibilities:

• Maintain organized workflow for efficient account processing and seamless task handover during absences.
• Adhere to departmental processes, consulting supervisors when needed.
• Demonstrate strong customer service skills to enhance department and organizational reputation.
• Foster teamwork and meet or exceed work standards.
• Possess working knowledge of compliance regulations and apply them effectively.
• Follow company policies and maintain accurate statistical data.
• Accurately perform order entry and resolve missing information.
• Utilize translation tools for entering codes into billing systems.
• Communicate effectively with internal and external stakeholders.
• Apply payment details accurately and handle overpayments or refunds.
• Review Explanation of Benefits from various payers.
• Investigate un-adjudicated claims and resolve outstanding accounts.
• Process Medicare denials and monitor payer rejections.
• Handle fast-paced, high call volume environments with strong multitasking skills.
• Focus on positive customer impact and utilize effective verbal and written communication.
• Research collection accounts and correct system errors.
• Perform additional duties and projects as assigned.

Qualifications:

• High school graduate or equivalent required.
• Minimum of 1 year billing experience working denials.  
• Working knowledge of Medicare and other third-party claims processing, ICD-10 and HCPCS/CPT coding, and medical terminology highly desirable.

Safety & Physical Demands:

• Visual acuity and hand-finger dexterity for extended computer work.
• Ability to sit at computer workstation for prolonged periods.
• Sound reasoning ability and independent judgment.
• Capacity to work within specified deadlines.
• Excellent communication and interpersonal skills.
• Ability to remain calm in stressful situations.
• Adherence to safety, ergonomic and health policies.
• Compliance with PPE requirements in lab or biohazard areas.
• Completion of required safety training and health evaluations promptly.
• Proactive approach to identifying and addressing safety hazards, promoting safety awareness.

CompuNet offers a full benefits package including Medical, Dental, and Vision coverage. Company paid life Insurance and 403b match. Paid holidays, vacation, sick and personal time. 

CompuNet Clinical Laboratories is an equal opportunity employer does not discriminate against any employee or applicant for employment.