Business Office Representative

Rochester Regional Health - - Responsibilities: Ensure full reimbursement is received by RRH for clinical services rendered by effectively and accurately managing a receivable.; Review and accurately process claim edits in a system work queue and handle claim adjustments and coverage changes as needed.; Review and process claim denials according to established processes and research denial issues via payer websites or communications; submit corrected claims and appeals.; Process account adjustments and refunds per department policy; follow-up with payers and coordinate resolution with Customer Service.; Acquire knowledge of system terminology, claim/denial/coverage concepts and HIPAA rules; use Epic tools to resolve denial issues and access necessary documentation.