Denials Underpayment Rep
Atlanta, GA · On-site
This representative reports to the Manager/Supervisor of Denials Management.ResponsibilitiesCompleting the research, follow-up, and resolution of denials and underpayments from third-party payors ...
Denials Underpayment Rep
Atlanta, GA · On-site
This representative reports to the Manager/Supervisor of Denials Management.ResponsibilitiesCompleting the research, follow-up, and resolution of denials and underpayments from third-party payors ...
Denials Management Coordinator - Revenue Integrity Description: Responsible for developing, implementing and managing a centralized program to promote greater efficiency with completing, tracking ...
Denials Management Coordinator - Revenue Integrity Description: Responsible for developing, implementing and managing a centralized program to promote greater efficiency with completing, tracking ...
Denials Management Coordinator - Revenue Integrity Description: Responsible for developing, implementing and managing a centralized program to promote greater efficiency with completing, tracking ...
Denials Management Coordinator - Revenue Integrity Description: Responsible for developing, implementing and managing a centralized program to promote greater efficiency with completing, tracking ...
... managing, and/or resolving appeals with third-party payers in a timely manner. Carries out ... Identifies, analyzes, and researches frequent root causes of denials and develops corrective action ...
... managing, and/or resolving appeals with third-party payers in a timely manner. Carries out ... Identifies, analyzes, and researches frequent root causes of denials and develops corrective action ...
Coding Denials Supervisor
Atlanta, GA · On-site
Review complex coding denials and provide guidance on ICD-10-CM, CPT, HCPCS, modifier usage ... Coach, mentor, and develop team members through ongoing feedback and performance management.
Coding Denials Supervisor
Atlanta, GA · On-site
Review complex coding denials and provide guidance on ICD-10-CM, CPT, HCPCS, modifier usage ... Coach, mentor, and develop team members through ongoing feedback and performance management.
Coding Denials Supervisor
Atlanta, GA · On-site
Review complex coding denials and provide guidance on ICD-10-CM, CPT, HCPCS, modifier usage ... Coach, mentor, and develop team members through ongoing feedback and performance management.
Coding Denials Supervisor
Atlanta, GA · On-site
Review complex coding denials and provide guidance on ICD-10-CM, CPT, HCPCS, modifier usage ... Coach, mentor, and develop team members through ongoing feedback and performance management.
REVENUE CYCLE MEDICAL GROUP SCHEDULE: Full Time, 8 HR Day Shift, 8-5 POSITION SUMMARY The Denials Management Analyst is responsible for thorough understanding of existing and future managed care ...
REVENUE CYCLE MEDICAL GROUP SCHEDULE: Full Time, 8 HR Day Shift, 8-5 POSITION SUMMARY The Denials Management Analyst is responsible for thorough understanding of existing and future managed care ...
REVENUE CYCLE MEDICAL GROUP SCHEDULE: Full Time, 8 HR Day Shift, 8-5 POSITION SUMMARY The Denials Management Analyst is responsible for thorough understanding of existing and future managed care ...
REVENUE CYCLE MEDICAL GROUP SCHEDULE: Full Time, 8 HR Day Shift, 8-5 POSITION SUMMARY The Denials Management Analyst is responsible for thorough understanding of existing and future managed care ...
Medical Billing AR / Denials Specialist
Lawrenceville, GA · Remote
$17.25 - $21/hr
Manages outstanding accounts to include following up with insurance carriers for overpayments ... Maintain denials productivity spreadsheet * Follows HIPAA guidelines in handling patient ...
Medical Billing AR / Denials Specialist
Lawrenceville, GA · Remote
$17.25 - $21/hr
Manages outstanding accounts to include following up with insurance carriers for overpayments ... Maintain denials productivity spreadsheet * Follows HIPAA guidelines in handling patient ...
Clinical Audit/Denials Specialist, RN
Atlanta, GA · On-site +1
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
Clinical Audit/Denials Specialist, RN
Atlanta, GA · On-site +1
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case ... including appealing denials. General: * Excellent written and verbal communication skills.
REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case ... including appealing denials. General: * Excellent written and verbal communication skills.
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
Qualifications REQUIRED Case Management * Graduate of an accredited school of nursing, with strong clinical case management experience * Three (3) years experience in Utilization Management/Case ...
Physician Advisor- Utilization Management & Clinical Documentation Integrity- ONSITE
Athens, GA · On-site
Review payer denials related to: * Medical necessity * Level of care * DRG downgrades * Write and support clinical appeal letters * Participate in denials management strategy * Identify systemic ...
Physician Advisor- Utilization Management & Clinical Documentation Integrity- ONSITE
Athens, GA · On-site
Review payer denials related to: * Medical necessity * Level of care * DRG downgrades * Write and support clinical appeal letters * Participate in denials management strategy * Identify systemic ...
Billing & Collections Specialist
$20 - $25/hr
Strong knowledge of insurance claims processing, benefits verification, denials management, and payer follow-up. * Experience using athenahealth / athenaOne billing and practice management software ...
Quick apply
Billing & Collections Specialist
$20 - $25/hr
Strong knowledge of insurance claims processing, benefits verification, denials management, and payer follow-up. * Experience using athenahealth / athenaOne billing and practice management software ...
Patient Accounts Representative- Denials and Appeals
Snellville, GA · On-site
$15.50 - $20.50/hr
Review denials for trends and help identify rootcauses. Work with coding and leadership to draft ... Manages Complexity: Making sense of complex, high quantity, and sometimes contradictory information ...
Patient Accounts Representative- Denials and Appeals
Snellville, GA · On-site
$15.50 - $20.50/hr
Review denials for trends and help identify rootcauses. Work with coding and leadership to draft ... Manages Complexity: Making sense of complex, high quantity, and sometimes contradictory information ...
Patient Accounts Representative- Denials and Appeals
Snellville, GA · On-site
$15.50 - $20.50/hr
Review denials for trends and help identify rootcauses. Work with coding and leadership to draft ... Manages Complexity: Making sense of complex, high quantity, and sometimes contradictory information ...
Patient Accounts Representative- Denials and Appeals
Snellville, GA · On-site
$15.50 - $20.50/hr
Review denials for trends and help identify rootcauses. Work with coding and leadership to draft ... Manages Complexity: Making sense of complex, high quantity, and sometimes contradictory information ...
Accounts Receivable Analyst
Atlanta, GA · Remote
$23 - $29.25/hr
... Denials Management, Payment Posting, and Credits and Refunds, for health care provider client * Review AR aging reports and work queues to identify unpaid and delayed claims. * Follow up with third ...
Accounts Receivable Analyst
Atlanta, GA · Remote
$23 - $29.25/hr
... Denials Management, Payment Posting, and Credits and Refunds, for health care provider client * Review AR aging reports and work queues to identify unpaid and delayed claims. * Follow up with third ...
Nurse Manager, Care Management
Albany, GA · On-site
The Manager CM recommends priorities and provides management for functions of utilization review, including but not limited to medical necessity, authorization, concurrent denials, and post-discharge ...
Nurse Manager, Care Management
Albany, GA · On-site
The Manager CM recommends priorities and provides management for functions of utilization review, including but not limited to medical necessity, authorization, concurrent denials, and post-discharge ...
Denials Manager information
What is a denial manager job description?
A denial manager oversees the process of reviewing and resolving insurance claim denials to ensure proper reimbursement. They analyze denial reasons, coordinate with healthcare providers and insurance companies, and implement strategies to reduce future denials, often using claims management software. Strong knowledge of billing, coding, and insurance policies is essential for this role.
What is the difference between Denials Manager vs Claims Supervisor?
| Aspect | Denials Manager | Claims Supervisor |
|---|---|---|
| Credentials | Typically requires healthcare administration, billing, or coding certifications | Often requires similar certifications, with additional supervisory or management training |
| Work Environment | Manages denial appeals, reviews claim rejections, collaborates with billing and coding teams | Oversees claims processing, supervises claims staff, ensures compliance with policies |
| Industry Usage | Common in healthcare, insurance, and hospital settings | Common in healthcare organizations, insurance companies, and billing departments |
While both roles focus on claims processing, the Denials Manager specializes in managing claim denials and appeals, whereas the Claims Supervisor oversees the entire claims process and staff. Both positions require healthcare billing knowledge and certification, but their primary responsibilities differ in scope and focus.
What are the top 5 denials in medical billing?
For a Denials Manager, the top five medical billing denials typically include missing or incorrect patient information, coding errors such as CPT or ICD-10 mistakes, lack of pre-authorization or referral, services deemed not medically necessary, and duplicate claims. Addressing these common issues requires strong attention to detail, accurate documentation, and familiarity with billing software and coding guidelines.
What are some common challenges faced by Denials Managers, and how can they effectively address them?
Denials Managers often encounter challenges such as identifying root causes of claim denials, staying updated with changing payer policies, and coordinating between billing, coding, and clinical teams. To address these challenges, Denials Managers typically implement robust tracking systems, conduct regular staff training, and foster open communication across departments. Proactively analyzing denial trends and collaborating on process improvements are key strategies to reduce future denials and enhance overall revenue cycle performance.
What is a Denials Manager?
A Denials Manager is a healthcare professional responsible for overseeing and managing the process of claim denials from insurance companies. Their primary role is to identify the causes of denied claims, implement strategies to reduce future denials, and ensure timely resolution and appeal of denied claims to maximize revenue for healthcare organizations. Denials Managers often collaborate with billing, coding, and clinical staff to ensure compliance with payer requirements and improve the overall reimbursement process. They play a crucial role in maintaining the financial health of medical practices or hospitals by minimizing lost revenue due to claim denials.
What are the key skills and qualifications needed to thrive as a Denials Manager, and why are they important?
To thrive as a Denials Manager, you need a deep understanding of medical billing, coding, insurance processes, and healthcare regulations, usually supported by a degree in healthcare administration or a related field. Familiarity with revenue cycle management systems, electronic health records (EHRs), and data analytics tools is essential, and certification like Certified Revenue Cycle Representative (CRCR) can be advantageous. Strong analytical thinking, problem-solving, and communication skills help in effectively leading teams and negotiating appeals with payers. These skills are critical for minimizing revenue loss, ensuring compliance, and optimizing reimbursement processes within healthcare organizations.
What is the 3 month rule for jobs?
The 3 month rule for a Denials Manager typically refers to the standard review period for insurance claim denials, where claims are reassessed or appealed within three months of denial. This timeframe helps ensure timely resolution and compliance with payer policies, often requiring the manager to track and document denials and appeals efficiently.
What is the highest paying job in healthcare management?
In healthcare management, the highest paying roles are typically executive positions such as Chief Executive Officer (CEO) or Chief Operating Officer (COO), with salaries often exceeding $150,000 annually. These roles require extensive experience, leadership skills, and often advanced degrees like an MBA or healthcare administration certification.
What cities in Georgia are hiring for Denials Manager jobs? Cities in Georgia with the most Denials Manager job openings:
Piedmont Healthcare rating
7.1
Based on 463 frontline employees who took The Breakroom Quiz
374th of 890 rated healthcare providers
Job description
OverviewCompleting the research, follow-up, and resolution of denials and underpayments from third-party payors according to payor contracts and processing any adjustments as required. This representative reports to the Manager/Supervisor of Denials Management.ResponsibilitiesCompleting the research, follow-up, and resolution of denials and underpayments from third-party payors according to payor contracts and processing any adjustments as required. This representative reports to the Manager/Supervisor of Denials Management.QualificationsEducation
- H.S. Diploma or General Education Degree (GED) Required
- 2 years of prior related healthcare Revenue Cycle experience, preferably within, A/R Follow Up or denials/underpayments Required
- Prior experience using Epic Preferred
- None Required
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About Piedmont
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Atlanta, GA, US
Year founded
1905