Medical Billing Representative

The University of Pittsburgh Student Health Services (SHS) is a comprehensive, AAAHC-accredited healthcare facility dedicated to advancing student wellness, academic success, and lifelong health. SHS provides high-quality, evidence-based primary care, prevention, health education, and pharmacy services tailored to the unique needs of the student population.

Reviews medical insurance claims and medical charges and ensures appropriately assigned diagnosis code and procedure code. Investigates insurance company denials, audits patient accounts, answers inquiries for assigned accounts, and updates related billing and financial documents and software.
Essential Functions

• Reviews medical insurance claims and medical charges; ensures appropriate diagnosis code and procedure code are assigned.

• Investigates denials received from insurance company; reviews and discusses medical records with appropriate personnel; reassigns codes accordingly.

• Audits patient accounts; verifies and updates insurance information as needed; ensures accuracy and compliance with policies, procedures, and regulations.

• Answers inquiries related to assigned accounts, billing processes, and payment plans.

• Maintains records of transactions; updates billing software, cash spreadsheets, and related information; prepares collection reports and assists with data entry.