Posted Date
6/16/2025
Full job description
Req# 8416
York Hospital
York Hospital, York, ME
Patient Billing
Full Time, Day Shift, 8-5
At York Hospital, we're more than a hospital. We are a team of providers, clinicians and staff members offering expertise within a Hospital setting, our community sites, and physician practices located throughout Southern Maine and the NH seacoast. Our caregivers' commitment is to make a positive difference in the lives of one another, our patients and our community by instilling our vision of Loving Kindness for all.
We have a new opening for a Billing Informatics Specialist. This is a full time 40 hrs/wk working in Patient Billing.
This position is responsible for:
Monitors bill holds and coordinates with other departments to resolve issues and facilitate timely claim submissions.
Works a section of the High Dollar report to ensure all claims are monitored in the report appropriately and timely.
Works with HIM and other applicable departments to resolve questions related to medical codes, modifiers, and or other elements present on the claim form.
Performs follow up to resolve aged claims and documents all reasons for reimbursement delays as well as actions taken within the patient accounting system.
Notes denial trends and informs the Billing Manager to mitigate future claim rejections.
Tracks the status and progress of denials and appeals.
Executes the denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third-party payers in a timely manner.
Conducts relevant research to assist with completing the appeals process and to stay informed on best practices and policy reforms.
Conducts internal and external correspondence accurately, clearly, concisely, and professionally while following organizational regulation.
Maintains data on the types of claims denied and root causes of denials and collaborates with team members to make recommendations for improvements and resolving issues.
Collaborates with team members to continually improve services and engages in process and quality improvement activities.
Complies with state and federal regulations, accreditation/compliance requirements, and policies, including those regarding fraud and abuse, confidentiality, and HIPAA.
In order to help us continue to provide exceptional patient/customer service experiences, we need you to have the following:
At least five years’ experience in healthcare billing, collections, payment processing, or denials management (denials management experience preferred).
At least two years’ experience using computer programs for tracking denials and appeals.
Associate degree required/Bachelors degree preferred. Working knowledge of CPT 4, ICD coding and medical billing procedures.
YORK HOSPITAL IS AN EQUAL OPPORTUNITY EMPLOYER.