Remote Cpt Coding Jobs in Chicago, IL (NOW HIRING)

Denial Management Specialist

Essential Job Functions

· Investigates insurance denials to identify action necessary to resolve the claim– including calls to payor and multiple computer systems, e.g., Epic, insurance portal, clearing house, etc.

· Able to analyze EOBs at a claim level

· Identifies claims needing correction and forwards to coding team/manager for review

· Determines best course of resolution for claim on first touch such as need for call to payer vs appeal of claim and calls/sends appeals via payor portal or payor appropriate appeal letters.

· Adjusts accounts appropriately, using correct denial codes

· Recognizes when additional assistance is needed to resolve denials and escalates appropriately

· Spots trends and reports them to management

· Works a minimum of 45 accounts per day with 95% accuracy

· Communicates effectively both verbally and in writing

· Documents all activities and findings in accordance with established policies and procedures.

· Performs special projects or other duties as assigned

· Maintains strictest confidentiality, adhering to all employer and government privacy standards, e.g., 42 CFR part 2 and HIPAA

· Maintains current knowledge of internal, industry and government regulations as applicable to denial management

Experience REQUIRED:

· High school graduate or equivalent

· 2 years of recent experience in medical revenue cycle

· Minimum of 1-year recent Epic experience with the Resolute/Billing module

· Knowledge and experience in working with health care insurance portals

· Familiarity with Excel

· Demonstrated problem solving ability

· Able to work effectively in a remote setting

· Strong organizational skills

Experience Preferred:

· 2 years previous experience in medical denial management

· Minimum of 1-year recent Epic experience with the Resolute/Billing module

· Knowledge and experience in working with health care insurance portals

· A good understanding of CPT, modifiers, HCPC, ICD-10 and medical terminology

· Working knowledge of Medicare, Medicaid and Commercial payor fee schedules and reimbursement documentation, e.g., payor rules, non-payable codes, etc.

· Good computer/tech knowledge (saving and locating files in OneDrive, Outlook, excel)

Skills:

· Ability to effectively prioritize and execute tasks

· Ability to make decisions based on available information and within scope of their authority

· Have excellent customer service skills and telephone interaction skills

· Excellent keyboarding skills, typing and 10 key

· Proficiency with MS Word and Excel

· Good work ethic

We are a 60-year-old family-owned accounts receivable firm, located in Oak Brook, IL, that assists Hospitals and Physicians with their accounts receivables. If you would like to further your career and join our successful team!