Denials Account Specialist II

**Join TriHealth as Denials Account Specialist II and make a meaningful impact by helping patients and providers resolve claims with accuracy and care!** Join **TriHealth** as a Denials Specialist II and bring your expertise to a mission‑driven health system that values accuracy, integrity, and teamwork. In this role, you’ll help protect the financial health of the organization by resolving payer issues, interpreting EOBs, and ensuring claims are processed correctly. We’re looking for someone with strong revenue cycle experience - ideally in hospital billing - who thrives on problem‑solving and investigating discrepancies to drive accurate outcomes. **Why Join Our Team:** - **Monthly team lunches** - We celebrate birthdays and anniversaries together, creating fun opportunities to connect with and enjoy great food. - **Inclusive, supportive culture** - Everyone is engaged, collaborative, and committed to helping one another succeed. - **Friendly, high‑energy environment** - A lively team spirit makes each day enjoyable and keeps us motivated. - **Growth and advancement** - There’s plenty of room to develop your skills and move into new opportunities within the department. Apply today and grow your career with a team that truly values you. **Location:** - TriHealth Norwood Office **Work Schedule:** - Full-time position (80 hours biweekly) - Day Shift - No Weekend or Holiday Rotation **Incentives & Benefits:** TriHealth offers a comprehensive benefits package which includes medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. Please view our benefits page: https://careers.trihealth.com/what-we-offer/benefits **Job Requirements:** - High School Diploma or GED Degree (Required) - 3 - 4 years’ experience in a related field (Required) - Specialized knowledge in Medicaid/Medicare billing, and other payer sources **Job Overview:** This position's principal purpose is to expedite positive cash flow, maximize reimbursement, and reduce/eliminate financial loss to department customers by efficient billing, follow-up and collections of patient accounts. Duties include: Submit charge information into appropriate system; Post payments; Follow-up on patient account balances including insurance/patient financial balances; Process the specified number of accounts on a daily basis based on customer specialty and unique billing requirements; Contact payers regarding payment; Resolve incorrect payment issues and ensure balances after insurance payments are correct, including entry of corrections into systems; Reconcile monthly reports; Demonstrate quality customer service to internal/external customers. **Job Responsibilities:** - Bills and collects dollars outstanding through interaction with payer and participates willing in payer communication. - Actively protects the financial resource of Bethesda Healthcare, Inc. - Completes assigned workload based on predefined key performance indicator on a daily basis ensuring accuracy. - Show an effort to consistently produce quality work. - Demonstrates proper customer service skills toward internal and external customers through prompt and courteous communications. - Participate in monthly billing meetings with customer contacts. - Prepares status report and submits agenda items to manager one business day prior to meeting. - Through cross training and experience, develops and maintains comprehensive knowledge and understanding of billing and follow-up procedures for all BWC and non-BWC payers. - Works with minimal supervisory oversight and exercised appropriate judgment in identifying instances which require management intervention. - Identifies and appropriately communicates process improvement with Manager in a timely manner. *Working Conditions:* Climbing - Rarely Hearing: Conversation - Consistently Hearing: Other Sounds - Frequently Kneeling - Occasionally Lifting 50+ Lbs. - Rarely Lifting <50 Lbs. - Occasionally Pushing - Occasionally Reaching - Rarely Sitting - Co…