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Denials Management Specialist
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Job Description
- Req#: JR104231
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to work with a leading healthcare system serving a large community
- Engage in meaningful work that directly impacts financial outcomes for healthcare services
- Work in a role that requires analytical skills and offers problem-solving challenges
What to Expect (Job Responsibilities):
- Validate dispute reasons and escalate payment variance trends or issues to management
- Generate appeals for denied or underpaid claims while resolving complex and aged accounts
- Conduct research on payer and governmental regulations, billing rules, and payment processes
- Provide feedback and recommendations to management regarding trends or issues in claims
- Collaborate with various departments to minimize ongoing denials and underpayments
What is Required (Qualifications):
- High School diploma or equivalent required; Associate's degree or higher preferred
- Minimum of at least 3 years of experience in a hospital business or medical office environment performing billing and/or collections
- Excellent knowledge of MS Office and familiarity with relevant computer software
- Strong analytical and problem-solving abilities with excellent organizational skills
- Knowledge of ICD-9, ICD-10, and CPT coding
How to Stand Out (Preferred Qualifications):
- CRCR or CPAR certification preferred
- Proven track record of successful performance in a similar role
- Strong team leadership skills and customer relations experience
- Ability to remain calm in difficult situations and handle multiple tasks simultaneously
- Strong written and oral communication skills
#HealthcareServices #ClaimsManagement #CareerOpportunity #AnalyticalSkills #ProblemSolving
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