Want to know if you’re a fit? Upload your resume and let our AI show you.
Skills
Accounts Receivableunmatched
Accounts Receivable Managementunmatched
Claims Processingunmatched
Communication Skillsunmatched
Credit and Collectionsunmatched
Current Procedural Terminology (CPT)unmatched
Denials Managementunmatched
Healthcareunmatched
ICD-9unmatched
Insuranceunmatched
Insurance Documentationunmatched
Medical Billingunmatched
Medicineunmatched
Microsoft Excelunmatched
Microsoft Officeunmatched
Microsoft Wordunmatched
Order Managementunmatched
Patient Care Denialsunmatched
Time Managementunmatched
Training/Teachingunmatched
Trend Analysisunmatched
Description
Job Requirements
Position Summary
The Denial Management Specialist is responsible for denial and AR management for the department as defined by their supervisor/manager.
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.
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
License/Registration/Certifications
N/A
Preferred Requirements
Preferred Education
Associates or Bachelor's degree in a Healthcare related field.
Preferred Experience
Focused denials and appeals management experience.
Preferred License/Registration/Certifications
CPC and/or CPC-H certification
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