Denial/Appeals Specialist-Patient Accounting

Overview

Now hiring a full time Denial/Appeals Specialist!

Responsible for tracking, appealing and resolving denied claims, as well as analyzing reimbursements according to contractual agreements. Performs a variety of duties including accounts receivable follow-up, customer service, correspondence response and daily reconciliation of activities. Identifies causal factors pertaining to denied claims and meets guidelines to ensure timely and accurate reimbursement for all billed charges

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Full Time - Exempt: No
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.
• Remote: Open to remote applicants in the United States, except for the following states: Wyoming, North Dakota, and Ohio

Ideal Candidate:

High school degree or GED required, short-term training on insurance collections and claims processing. Minimum two years experience in insurance follow-up, billing and collections.

Qualifications

• High school degree or GED required, short-term training on insurance collections and claims processing.
• Minimum two years experience in insurance follow-up, billing and collections.
• One year of similar medical facility, physicians office or experience with a major carrier in claims processing preferred.
• Demonstrated ability to communicate effectively via telephone and in writing.
• Computer literate.
• Must be able to work closely with co-workers

Education Essential: High School Diploma or GED

Responsibilities

• Performs accounts receivable reimbursement analysis and denial management activities for their assigned payers/accounts using monthly aged account work queues and/or A/R reports.
• Responsible for identifying and documenting insurance payer issues as they arise. Must communicate all issues to teammates and supervisor. Responsible for maintaining files containing all pertinent information for each account to include correspondence, EOB s, claims, letters of appeal, medical records etc.
• Must be an effective team member with good communication skills. Must participate …