Position Summary: 

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. 

Essential Functions and Responsibilities:

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.  Tracks and investigates denial trends/ root cause Assists with claim audits as necessary Makes management aware of any issues or changes in the billing system, insurance carriers, and/or network. Obtain retro authorizations and submit to payers for reimbursement. Ability to write non-clinical appeals with demonstrating proficiency with timely and successful submissions. As needed, participates in A/R clean-up projects or other projects identified by direct supervisor or CBS management.   Works independently with other departments to resolve A/R and payer issues.

Qualifications

 Required:

·         Associate degree required.

·         Minimum of 3 years in a hospital or physician billing office.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans 

Additional Information Schedule: Full-time Requisition ID: 25000246 Daily Work Times: Standard Business Hours Hours Per Pay Period: 80 On Call: No Weekends: No