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 - Consistently 
Standing - Rarely 
Stooping - Occasionally 
Talking - Consistently 
Use of Hands - Consistently 
Color Vision - Occasionally 
Visual Acuity: Far - Frequently 
Visual Acuity: Near - Consistently 
Walking – Frequently

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:

Serve: ALWAYS... 
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello" 
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist 
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
 

Excel: ALWAYS... 
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met 
• Offer patients and guests priority when waiting (lines, elevators) 
• Work on improving quality, safety, and service

Respect: ALWAYS... 
• Respect cultural and spiritual differences and honor individual preferences. 
• Respect everyone's opinion and contribution, regardless of title/role. 
• Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS... 
• Value the time of others by striving to be on time, prepared and actively participating. 
• Pick up trash, ensuring the physical environment is clean and safe. 
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS... 
• Acknowledge wins and frequently thank team members and others for contributions. 
• Show courtesy and compassion with customers, team members and the community

Job keywords:

Bill and Account Collector / Billing and Posting Clerk / Medical Records Specialist