Billing/Specialist / Insurance Claims Processing at Recovery & Wellness Centers of Midwest Ohio

Greenville, Ohio, United States -

Full Time

Start Date

Immediate

Expiry Date

11 May, 26

Salary

0.0

Posted On

10 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Review, Appeals, Follow-Up, Payer Guidelines, Coding Requirements, Documentation Issues, Process Improvements, Data Reporting, Billing Software, EHR, Payer Portals, Teamwork, Communication Skills, Problem Solving, Ethics, Accountability

Industry

Mental Health Care

Description

Description Values: Employees of Darke County Recovery Services, DBA Recovery and Wellness Centers of Midwest Ohio are expected to value highest ethical standards, quality clinical care, and good customer service. We also value quality communication skills in a collaborative, multidisciplinary and often multi-agency service environment Responsibilities: Claims Review & Resolution Examine denied or underpaid insurance claims to determine reasons for denial. Research payer guidelines, coding requirements, and policy rules to determine appropriate next steps. Correct claim errors, gather additional documentation, and resubmit or appeal claims as necessary. Maintain accurate records of denial reasons, corrective actions, and resolution outcomes. Appeals & Follow-Up Prepare and submit timely appeals supported with medical records, coding justification, or policy clarification. Communicate with insurance companies to dispute incorrect denials or request reconsideration. Track open appeals and follow up until payment, partial approval, or final determination. Collaboration & Communication Coordinate with physicians, coders, billing staff, and administrative teams to resolve documentation issues. Educate staff on common denial trends and recommend process improvements. Communicate clearly with patients when additional information is needed. Data & Reporting Document denial categories and recovery metrics for management review. Identify recurring denial patterns and work with leadership to reduce preventable denials. Utilize billing software, electronic health records (EHR), and payer portals to complete daily tasks. Competencies: Teamwork Judgment/Decision Making Communication Skills Trustworthiness & Ethics Accountability Communication, Verbal and Written Problem solving Requirements Requirements: High school diploma/GED. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand, walk, sit, talk and hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Experience: 1-2 years prior Medical Billing Experience 1-2 years’ experience performing general office duties 1-2 years’ experience using Microsoft Office Operation Systems and Applications

Responsibilities

The role involves examining denied or underpaid insurance claims, researching payer guidelines, correcting errors, and resubmitting or appealing claims as necessary. Responsibilities also include preparing timely appeals, communicating with insurance companies, and tracking open appeals until resolution.