Previous experience with hospital billing and reimbursement, physician billing and reimbursement, Medicare and Medicaid denials and appeals, commercial payer denials and appeals, third-party contracts, NCQA guidelines for denials and appeals, Federal and State regulations relating to denials and appeal and Fair Debt Collection Practices. The Patient Accounting Specialist III is responsible for processing complex transactions such as complex services, global transplant cases, payer audits, payer withholds and managing complex data from multiple sources; reviewing and resolving denied and underpaid/overpaid claims and carrying out the appeals process.