The Denial Management Specialist is responsible for denial and accounts receivable management for the department as defined by their supervisor/manager.
Only applicants from the following states may apply: Alabama, Arizona, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia, and Wisconsin.
Responsibilities include researching and resolving outstanding denials, managing insurance appeals, handling denial-related accounts receivable, identifying denial trends, communicating trends to management, organizing workflow according to departmental standards, managing correspondence and ADR requests, completing special projects, and preparing for AR denial meetings as required.
- High school diploma or equivalent
- 4 years of experience in medical billing with exposure to denials, appeals, insurance collections, and related follow-up
- Working knowledge of ICD-9 and CPT-4 coding
- Strong understanding of explanation of benefits (EOBs), remittance codes, and remark codes
- Familiarity with multiple payer requirements for claims processing
- Proficiency with Microsoft Office, especially Excel and Word
- Strong communication skills
Preferred:
- Associate's or bachelor's degree in a healthcare-related field
- Focused denials and appeals management experience
- CPC and/or CPC-H certification
Location
South Carolina, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago