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Addison Group

Medical Collector

Plano, TX · Remote

$24 - $26/hr

Remote (Candidates must reside in San Antonio, TX ) Openings: 2 Pay Rate: $24-$26/hour Hours ... Review and address Explanation of Benefit (EOB) denials and remittance advice * Process manual and ...

Harris

$26/hr

Knowledge and understanding of Explanation of Benefits (EOB), state, and federal guidelines ... Remote work and more! About MEDHOST: MEDHOST, founded in 1984 and headquartered in Franklin ...

Harris

$26/hr

Knowledge and understanding of Explanation of Benefits (EOB), state, and federal guidelines ... Remote work and more! About MEDHOST: MEDHOST, founded in 1984 and headquartered in Franklin ...

MedHQ, LLC

Patient Financial Services Rep

Wichita, KS · Remote

Explanation of Benefits (EOB) Interpretation: * Interpret and explain Explanation of Benefits (EOB ... This job is remote. **Applicants must be legally authorized to work in the United States. We are ...

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Specialist-Denials Management (Remote)

Specialist-Denials Management (Remote)

Spartanburg Regional Healthcare System

Spartanburg, SC • Remote

Full-time

Re-posted 18 days ago

Spartanburg Regional Healthcare System rating

6.7

Company rating: 6.7 out of 10

Based on 117 frontline employees who took The Breakroom Quiz

526th of 886 rated healthcare providers

Job description

Job Requirements

Position Summary

The Denial Management Specialist is responsible for denial and AR management for the department as defined by their supervisor/manager. 

* Only Applicants from the following states: Alabama, Arizona, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia, Wisconsin.

Minimum Requirements

Education

  • High School Diploma or equivalency

Experience

  • 4 years' experience in medical billing, setting with exposure to denials, appeals, insurance collections and related follow-up.
  • Must have good knowledge of ICD9 and CPT-4 coding
  • Must have a good working knowledge with insurance explanation of benefits (EOB) and comprehensive understanding of remittance and remark codes.
  • Be familiar with multiple payer requirements for claims processing
  • Solid skills with Microsoft office with a focus on Excel and Word. 
  • Good Communication Skills

License/Registration/Certifications

  •  N/A

 

Preferred Requirements

Preferred Education

  • Associates or Bachelor's degree in a Healthcare related field.

Preferred Experience

  • Focused denials and appeals management experience.  

Preferred License/Registration/Certifications

  • CPC and/or CPC-H certification

Core Job Responsibilities

  • Research and resolve all outstanding denials within workque and complete all necessary follow up within a timely and accurate manner
  • Identify all denial trends and provide education of steps to prevent future avoidable denials. 
  • Initiate/manage all insurance appeals in a timely manner
  • Manage outstanding AR related to denials.
  • Communicate all denial trends and denial increases to direct supervisor/manager in order to positively affect the volume of denials
  • Organize the workflow to ensure that denials are worked according to departmental policy and standards.
  • Manage correspondences and any ADR requests as defined within department workflow procedure to ensure timeless and accuracy of response. 
  • Complete special projects as assigned by Supervisor/Manager
  • Prepare/attend AR denial meetings as required.


 


Employment Type: FULL_TIME

What Spartanburg Regional Healthcare System employees say

Pay

Benefits

Hours and flexibility

Workplace

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About Spartanburg Regional Healthcare System

Sourced by ZipRecruiter

Spartanburg Regional Healthcare System is a leader in the healthcare industry, located in Spartanburg, SC, US. As a comprehensive health system, it offers services encompassing everything from wellness, prevention, and care coordination to specific medical treatments for a wide range of diseases and health issues. Spartanburg Regional Healthcare System was founded in 1921 and has since developed a reputation for excellence and innovative care, growing to include six hospitals, 100 medical offices, 8,000 associates and more than 900 medical staff.

Industry

Recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Spartanburg, SC, US

Year founded

1921

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