Insurance Claims Specialist HB
Core
Manages patient account balances, submits accurate claims, and ensures compliance with federal/state billing regulations to support hospital financial viability.
Role type
Medical billing specialist
Builds
Patient financial accounts and claim submissions for WVU Medicine hospitals
Domain
Healthcare revenue cycle management
Required skills
Medical billing, claims submission, HIPAA compliance, third-party payer relations, denial management, account reconciliation, medical terminology, ICD-10/CPT coding knowledge, business math
Preferred skills
Medical office experience, knowledge of revenue cycle operations, payer portal navigation
Responsibilities
Submits accurate and timely claims to third party payers; resolves claim edits and account errors; follows up with payers to ensure collections; investigates and resolves claim denials; reconciles billing account transactions; contacts payers to resolve unpaid claims; processes mail returns and rejected claims; maintains confidentiality of PHI.
Seniority
Individual Contributor, entry to mid-level