Full employer posting
Responsibilities This position serves as a senior specialist responsible for resolving the most complex claim issues, denials, and payer escalations. This role requires advanced knowledge of payer rules, regulatory requirements, and audit ready documentation. Representative III acts as a subject matter expert, supports training and quality initiatives, and partners with leadership to improve processes and payer performance.
Qualifications Education H. S. Diploma or General Education Degree (GED) Required Work Experience 3 years of progressively responsible experience in hospital billing, follow up, denial management, or related revenue cycle functions.
Required Experience with complex payer types (Medicare Advantage, Medicaid Managed Care, Workers’ Compensation, TPL, MSP). Preferred Advanced Epic proficiency. Preferred Experience supporting training, quality review, or process improvement.
Preferred Business Unit : Company Name Piedmont Healthcare Corporate
About the role
This position serves as a senior specialist responsible for resolving the most complex claim issues, denials, and payer escalations. This role requires advanced knowledge of payer rules, regulatory requirements, and audit ready documentation. Representative III acts as a subject matter expert, supports training and quality initiatives, and partners with leadership to improve processes and payer performance.