Business Office Representative - Senior
$39,520–$46,800 year
On-site · Rochester, New York, United States
Job Summary
Senior Business Office Representative responsible for managing receivables and ensuring timely reimbursement for clinical services. Handles claim edits, denials, and payer requests; submits corrected claims and appeals; documents actions; leads team discussions on new procedures and denial types; maintains knowledge of billing terminology and HIPAA rules; proficient in Epic and payer websites to resolve denial issues; collaborates with Customer Service and other departments to ensure accuracy of authorizations, medical records, and appeals; strong problem-solving, analytical, and communication skills; experience with Medicare/Medicaid insurance compliance and CPT/HCPCS coding; previously involved in denial trend analyses and audits. Location: Rochester NY; full-time, day shift, 40 hours/week.
Required Qualifications
- None Required
Desired Qualifications
- 2 years work experience in a healthcare setting preferred
- Proficient working knowledge of assigned receivable systems
- General knowledge of Medicare, Medicaid and insurance compliance issues preferred
- Familiarity with ICD-9 diagnosis and procedure codes as well as CPT/HCPCS codes helpful
- Knowledge of UBO4 billing form and 1500F05 specific payor requirements preferred
- Proficiency in a variety of computer applications and spreadsheet applications and common office equipment
- Excellent problem solving, organizational and oral and written communication skills required
- Strong communication, analytical and PC skills highly desired
- Excellent interpersonal, organizational, communication, attention to detail and follow through skills
- Flexibility and ability to work as a team player and to handle simultaneous tasks
- Successful completion of annual age and job specific competencies and skill verification tools required
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