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.

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

Piedmont Healthcare Corporate