Business Office Representative
Core
Manage medical billing receivables, resolve claim denials, process payments, and ensure accurate reimbursement for clinical services.
Role type
Medical billing and revenue integrity specialist
Builds
Accurate insurance claims and payment postings for clinical services
Domain
Healthcare billing and insurance
Required skills
Medical billing, claim denial resolution, payment posting, Epic system navigation, HIPAA compliance, data entry, spreadsheet applications
Preferred skills
Medical office experience, knowledge of UBO4 billing forms, familiarity with 1500F05 payer requirements
Technologies
Epic, insurance websites, spreadsheet applications
Responsibilities
Review and process claim edits and adjustments; research and resolve claim denials via payer portals and phone calls; post remittances and account adjustments; document actions and follow up on payer responses; respond to patient complaints regarding coverage and responsibility; participate in team meetings to update policies based on new denial types or system updates.