Denials Management Specialist
Option 1 Staffing Services, Inc., San Francisco, California, United States, 94199
Excellent Opportunity to join a World-Renowned Healthcare Facility!!
Option 1 Staffing is seeking a motivated individual with extensive experience in commercial insurance and government systems to mitigate financial risk caused by denial of payments.
Key Responsibilities:
Collaborate with Revenue Cycle personnel, case managers and physicians to appeal clinical and technical denials
Review, coordinate and monitor the clinical denials and appeals process
Collaborate with management to develop successful appeal strategies
Create letter templates, reference and educational materials for staff regarding regulatory standards relating to denials
Facilitate reimbursement through appeal writing
Provide training for staff as a clinical subject matter expert for clinical denials and provide feedback for process and workflow changes
Qualifications:
Bachelor of Science preferred
Seven years clinical/patient care experience
Prior authorization process for all providers, ordering and rendering
Five years in utilization review using tools such as Millimann, Interqual, etc
Demonstrates a strong understanding of government and commercial insurance programs and state and federal regulations
If you are an experienced Denials Management Specialist, confident in your knowledge of state and federal regulations and excellent communication skills, please apply!
Option 1 Staffing is an award-winning, recognized leader in staffing and recruiting. We specialize in placing the highest caliber of Non-Clinical Healthcare, Information Technology, Supply Chain, Administrative, and Accounting/Finance professionals in contract and direct-hire opportunities across the nation.
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Key Responsibilities:
Collaborate with Revenue Cycle personnel, case managers and physicians to appeal clinical and technical denials
Review, coordinate and monitor the clinical denials and appeals process
Collaborate with management to develop successful appeal strategies
Create letter templates, reference and educational materials for staff regarding regulatory standards relating to denials
Facilitate reimbursement through appeal writing
Provide training for staff as a clinical subject matter expert for clinical denials and provide feedback for process and workflow changes
Qualifications:
Bachelor of Science preferred
Seven years clinical/patient care experience
Prior authorization process for all providers, ordering and rendering
Five years in utilization review using tools such as Millimann, Interqual, etc
Demonstrates a strong understanding of government and commercial insurance programs and state and federal regulations
If you are an experienced Denials Management Specialist, confident in your knowledge of state and federal regulations and excellent communication skills, please apply!
Option 1 Staffing is an award-winning, recognized leader in staffing and recruiting. We specialize in placing the highest caliber of Non-Clinical Healthcare, Information Technology, Supply Chain, Administrative, and Accounting/Finance professionals in contract and direct-hire opportunities across the nation.
#J-18808-Ljbffr