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Denials Management Specialist - Remote

Home Health Focus AI • Remote (Montgomery, PA, US) • 5d ago

Employer Industry: Healthcare Services

Why Consider This Job Opportunity

Opportunity for career advancement and growth within the organization
Collaborative work environment focused on resolving complex issues
In-depth training provided to stay current on regulations and policies
Chance to make a significant impact on revenue integrity and patient financial services
Supportive team culture that values professionalism and positive interactions

What To Expect (Job Responsibilities)

Validate dispute reasons and escalate payment variance trends to management
Generate appeals for denied or underpaid claims, ensuring compliance with payer guidelines
Conduct thorough research on payer regulations, billing rules, and managed care contracts
Document all collection activities accurately and thoroughly
Collaborate with various departments to minimize ongoing denials and underpayments

What Is Required (Qualifications)

High school graduate or equivalent; Associate's degree or higher preferred
Minimum of 3 years of experience in a hospital business or medical office environment performing billing and/or collections
Advanced knowledge of 1500 and/or UB-04 forms and Explanation of Benefits (EOB) interpretation
Intermediate knowledge of CPT and ICD-10 codes
Excellent verbal and written communication skills

How To Stand Out (Preferred Qualifications)

Advanced knowledge of insurance billing, collections, and terminology
Strong critical thinking and analytical skills
Self-motivated with advanced business letter writing skills
Knowledge of reimbursement methodologies for various payer groups
Intermediate PC experience with knowledge of Excel and Word applications

#Healthcare #Billing #ClaimsManagement #CareerOpportunity #ProfessionalDevelopment

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