Jobs at WVU Medicine

Manage patient account balances by submitting accurate claims, resolving denials and claim edits, following up with payers, reconciling transactions, using payer portals, maintaining compliance with HIPAA and billing regulations, producing reports, and providing patient customer service to maximize revenue cycle performance.

Manage patient account balances by submitting accurate claims, resolving claim edits and denials, following up with third-party payers, reconciling billing transactions, using payer portals, maintaining HIPAA compliance, and supporting revenue cycle reporting and productivity goals.

Manage hospital patient account balances and insurance claims: submit accurate claims, resolve denials and edits, follow up with third-party payers, use payer portals and billing systems, support revenue cycle reporting, maintain compliance with federal/state regulations and HIPAA, and serve as a resource and super user for billing applications.

Obtain prior authorizations for outpatient elective infusions and injections, verify payer requirements and coding (ICD-10/CPT), submit and follow up on authorizations and appeals, liaise between clinics, pharmacists, and Patient Financial Services, and maintain documentation/work queues in Epic and Outlook to ensure reimbursement.

The Insurance Claims Specialist manages patient account balances, submits claims, resolves errors, and provides customer service regarding claims and billing.

Manage patient account balances by submitting accurate claims, following federal/state and third-party billing rules, resolving denials and claim edits, verifying claim status via payer portals, reconciling transactions, and providing customer service while maintaining HIPAA compliance and departmental productivity goals.

Obtain prior authorizations for elective procedures, verify insurance eligibility and benefits, code cases, review clinical documentation, follow up on authorizations and denials, assist denial management and retro-authorizations, and communicate with providers, schedulers, and financial clearance teams to minimize delays and revenue loss.

Design and build BI solutions and dashboards, perform data analysis and SQL development, apply data governance and security, and lead requirements gathering and project coordination to drive process improvement and reporting accuracy across the health system.

Manage patient account balances by submitting accurate claims, resolving claim edits and denials, following up with third-party payers, reconciling billing transactions, maintaining productivity, ensuring HIPAA compliance, and providing customer service to maximize cash collections.

Design, implement, and optimize enterprise data architecture and management for healthcare analytics. Lead data solutions using Microsoft Fabric and Power BI, ensure data governance, integrate imaging and EMR systems, troubleshoot ETL/SSIS, manage projects, mentor staff, and ensure HIPAA-compliant data practices.

Manage patient account balances through accurate claim submission, payer follow-up, denial management, and account reconciliation. Use payer portals and phone/email to resolve unpaid or rejected claims, maintain productivity metrics, comply with HIPAA, and support revenue cycle reporting and improvement initiatives.

Designs and delivers training across clinical revenue cycle functions (CDI, coding, denials, UR). Develops curricula, tip sheets, and audits; provides case-based support, monitors denial trends, and partners with leaders to improve documentation, compliance, and financial performance using Epic and revenue cycle analytics.

Manage denied claims and accounts receivable by investigating denials, communicating with payers and clinics, composing non-clinical appeals, posting adjustments, maintaining compliance with billing regulations, and supporting revenue cycle workflow and reporting.