Medical Billing and Denials Specialist

Rochester Regional Health; Rochester; On-site; GBP 80,000 - 100,000; Full time

Job summary

A healthcare organization is seeking a Medical Billing and Denials Specialist in Rochester, UK. This role involves managing the billing process, resolving claims issues, and ensuring timely reimbursements. Key responsibilities include submitting insurance claims, reviewing denials, and providing customer service to patients. The ideal candidate should have a background in medical billing, strong communication skills, and the ability to manage multiple tasks efficiently. This position offers a competitive pay range of $19.86 - $28.82 per hour.

Qualifications

• High school graduate or equivalent required.
• Bachelor’s degree in healthcare or business administration preferred.
• At least 1 year of experience in medical billing and denials preferred.

Responsibilities

• Submit and track insurance claims and resolve billing issues.
• Review denied claims and prepare appeal letters.
• Respond to patient inquiries and maintain documentation.
• Ensure compliance with HIPAA and manage workload effectively.

Skills

Medical billing

Claims management

Customer service

Time management

Communication skills

Education

Bachelor’s degree in healthcare or business administration

High school graduate or equivalent

Certification in medical billing

Job description

Job Title: Medical Billing and Denials Specialist
Department: Revenue Cycle
Location: SLH - Regional Administrative Campus
Hours Per Week: Per Diem
Schedule: Between 8am-4pm

SUMMARY

A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims, and ensuring timely reimbursement for healthcare services. This role plays a critical part in the revenue cycle management of the healthcare organization by identifying trends in denials and taking corrective actions.

RESPONSIBILITIES

• Medical Billing & Claims Management: Submit and track insurance claims, resolve denials and billing edits, process remittances and adjustments, and ensure timely and accurate account resolution in line with payer requirements.

• Appeals & Reimbursement Review: Conduct detailed reviews of denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to ensure successful claim outcomes.

• Customer Service & Communication: Respond to patient inquiries, verify insurance eligibility and authorizations, and maintain thorough documentation while ensuring clear communication across Revenue Cycle teams.

• Compliance & Operational Excellence: Maintain HIPAA confidentiality, meet productivity benchmarks, stay current with billing policies, and manage workload with strong time management, organization, and communication skills.

PREFERRED QUALIFICATIONS

• High school graduate or equivalent
• Bachelor’s degree in healthcare or business administration
• Minimum 1 year medical billing and denials, customer service and relevant finance experience in a health care organization a plus
• Certification in medical billing

PHYSICAL REQUIREMENTS

S - Sedentary Work - Exerting up to 10 pounds of force occasionally. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PAY RANGE

$19.86 - $28.82