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Specialist-Denials Management (Remote) Full time

sharris8888

Contributor
Messages
10
Location
Campobello, SC
[/URL]

* Only Applicants from the following states: Alabama, Arizona, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia, Wisconsin.
Core Job Responsibilities

  • Research and resolve all outstanding denials within workque and complete all necessary follow up within a timely and accurate manner
  • Identify all denial trends and provide education of steps to prevent future avoidable denials.
  • Initiate/manage all insurance appeals in a timely manner
  • Manage outstanding AR related to denials.
  • Communicate all denial trends and denial increases to direct supervisor/manager in order to positively affect the volume of denials
  • Organize the workflow to ensure that denials are worked according to departmental policy and standards.
  • Manage correspondences and any ADR requests as defined within department workflow procedure to ensure timeless and accuracy of response.
  • Complete special projects as assigned by Supervisor/Manager
  • Prepare/attend AR denial meetings as required.
Minimum Requirements

Education

  • High School Diploma or equivalency
Experience

  • 4 years' experience in medical billing, setting with exposure to denials, appeals, insurance collections and related follow-up.
  • Must have good knowledge of ICD9 and CPT-4 coding
  • Must have a good working knowledge with insurance explanation of benefits (EOB) and comprehensive understanding of remittance and remark codes.
  • Be familiar with multiple payer requirements for claims processing
  • Solid skills with Microsoft office with a focus on Excel and Word.
  • Good Communication Skills
 
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