About this role
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.