Denials Management Specialist- Remote
Spartanburg Regional Healthcare System
Full time
Healthcare
United States
Hiring from: United States
Job Requirements
Position Summary
100% Remote | Applicants must reside in one of the following states: AL, AZ, CT, DE, FL, GA, IN, KS, KY, LA, MD, MI, NC, PA, RI, SC, VA, WV, or WI.
The Denial Management Specialist is responsible for denial and AR management for the department as defined by their supervisor/manager.
Minimum Requirements
Education
Preferred Education
Position Summary
100% Remote | Applicants must reside in one of the following states: AL, AZ, CT, DE, FL, GA, IN, KS, KY, LA, MD, MI, NC, PA, RI, SC, VA, WV, or WI.
The Denial Management Specialist is responsible for denial and AR management for the department as defined by their supervisor/manager.
Minimum Requirements
Education
- High School Diploma or equivalency
- 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
- N/A
Preferred Education
- Associates or Bachelor's degree in a Healthcare related field.
- Focused denials and appeals management experience.
- CPC and/or CPC-H certification
- 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.
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