Specialist-Denials Management (Remote)
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 Prepare/attend AR denial meetings as required.