Claims and Denial Specialist

Virginia Physicians for Women is looking for a Claims and Denial Specialist to join our Midlothian Turnpike office. We are looking for an individual who has excellent customer service skills, strong work ethic and the ability to multitask in a high volume environment.

Essential Functions:

  • Researches and analyzes denials and outstanding claims data and coordinates recovery actions to reach a resolution
  • Meets daily claims follow up productivity standards to minimize claims aging
  • Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of denials
  • Develops reporting tools that effectively measure and monitor processes throughout the denials management process in order to support process improvement
  • Prioritizes activities to work overturns in a timely manner to alleviate untimely filings
  • Researches, responds and documents insurer and patient correspondence/inquiry notes regarding coding coverage, benefits and reimbursement on patient accounts
  • Researches rejections included in EOB’s for resolution and follows up appropriately
  • Makes management aware of any issues or changes in the billing system, insurance carriers and /or networks
  • Supports other areas of the business office as needed

Desired Skills and Knowledge:

  • Demonstrates proficiency in medical insurance, automated billing systems and medical software
  • Knowledge of CPT, HCPCS and ICD10 coding
  • Demonstrates good judgment in handling situations not covered by written or verbal instruction and seeks guidance as needed
  • Perform work within appropriate time frame, accurately and in a timely manner in periods of increased work load
  • Ability to recognize and resolve billing problems

Education/ Certifications:

  • 3-5 years previous medical billing experience required
  • CPC preferred


To apply, please send your cover letter and resume to with “Claims and Denial Specialist” in the subject line.