Billing Rejection Specialist

Key Responsibilities Clearinghouse Monitoring: Daily review and management of clearinghouse portals to capture, sort, and action front-end rejections. Direct Payer Communication: Contact insurance companies directly via phone or web portals to investigate complex claim rejections, verify active patient eligibility, and check benefit coverage details. Root Cause Analysis: Investigate why claims were rejected by the clearinghouse or payer, distinguishing between demographic errors, missing insurance details, coding discrepancies, and provider credentialing mismatches. Claim Correction & Resubmission: Efficiently update and correct patient demographics, insurance policy numbers, CPT/ICD-10 codes, and modifiers within the practice management or EHR software before resubmitting.…