Denials and Appeals Specialist

Denials and Appeals Specialist

Work Location: Satellite Location

Req Number: 35021

Department Name: Prof Rev Cycle Svcs

Shift: Days/No Weekends

Position Status: Full Time

Employment Status: Regular

This button is used to apply to this position only.If you are attempting to apply to multiple positions, returnto the Search Results or Job Cart.

Position Description

The Denials and Appeals Specialist is responsible for timely and accurate resolution of denied insurance claims. This position reviews all pertinent information to ensure denials are worked in a timely manner and appeals for the denied claims are submitted appropriately. The Denial and Appeals Specialist will use payor guidelines, carrier websites, coding edits tools such as Encoder, etc., and communication with the AU Health coding staff to determine to appropriate steps needed to resolve the denial.

Position Requirements

High School Diploma, GED or equivalent from a recognized State or Federal accrediting organization. 1 year or more of experience in Patient Accounting in Healthcare Environment. Excellent internal/external customer service skills, knowledge of insurance regulations, payment guidelines, and policies, ability to communicate and work with payors to get accounts paid timely and accurately.

Preferred Requirements

Associates Degree in Healthcare. 2 years or more of experience in Hospital or Professional Billing Experience. Proficient in Medicare Part A and B, Medicaid billing with an understanding of LCD/NCD, MUE and CCI edits. Medical terminology, knowledge of insurance and reimbursement policies. CPB or CPC certification.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.