Full employer posting
The Denials Management Specialist is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The specialist will work independently while managing their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered.
and Responsibilities as Assigned : 1. Monitors denial work queues and reports in accordance with assignments from direct supervisor. Maintains required levels of productivity while managing tasks in work queues to ensure timeliness of follow-up and appeals. 2.
Tracks and investigates denial trends/ root cause. 3. Assists with claim audits as necessary. 4. Makes management aware of any issues or changes in the billing system, insurance carriers, and/or network. 5.
Obtain retro authorizations and submit to payers for reimbursement. 6. Ability to write non-clinical appeals with demonstrating proficiency with timely and successful submissions. 7. As needed, participates in A/R clean-up projects or other projects identified by direct supervisor or CBS management. 8.
Works independently with other departments to resolve A/R and payer issues. 9. Participates in departmental and team meetings involving discussion of A/R processes and trends. 10. Knowledge of payer edits, rejections, rules, and how to appropriately respond to each to resolution.
Required: High School Diploma or GED 7 years experience in Patient Accounting or Patient Access experience OR Associates Degree with 3 years of Patient Accounting or Patient Access experience
About the role
The Denials Management Specialist is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The specialist will work independently while managing their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered.