Denials Management Specialist
NorthShore University HealthSystem, Arlington Heights, IL, United States
Hourly Pay Range
$22.14 - $33.21 - The hourly pay rate offered is determined by a candidate’s expertise and years of experience, among other factors.
Position Highlights
Position: Denial Management Specialist
Location: Arlington Heights, IL
Full Time/Part Time: Full Time
Hours: Monday-Friday, standard business hours
Overview Reviews claim denials which pertain to medical necessity, pre-certification, authorization, and level of care requirements. This involves interaction with Physician Practices, Providers and Payers.
Responsibilities
Reviews and resolves denied patient insurance claims.
Works closely with internal departments in determining accurate denial and process for appeal. Contacts insurance companies/payer or patients to gather information necessary to complete the appeal process.
Sends appeals to insurance companies regarding denials by resubmitting corrected claim, submitting medical records and writing appeals letters in a timely manner.
Provides process improvement recommendations to Supervisor to decrease future denials.
Utilizes software tools to identify denial, trends and payer issues. Shares findings with stakeholders.
Follows up on pending claim denials after appeal has been processed – by the insurance company.
Collaborates in the collection of data and sends monthly "Managed Care Denial Report" to appropriate department Leaders including: Physician Coding Manager; Physician Billing Manager and Director, VP of EEH Physician Practices and Vice President of EEH Revenue Cycle.
Maintains positive working relationships both externally and internally.
Qualifications
Education:
High School Required
Experience:
2 Years previous patient billing or 2 Years managed care experience
Skills:
Extensive computer knowledge and experience. Knowledge of standard billing guidelines, CPT/ICD9 coding, usual and customary (U& C) schedules
Benefits
Career Pathways to Promote Professional Growth and Development
Various Medical, Dental, and Vision options
Tuition Reimbursement
Free Parking at designated locations
Wellness Program Savings Plan
Health Savings Account Options
Retirement Options with Company Match
Paid Time Off and Holiday Pay
Community Involvement Opportunities
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
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Position Highlights
Position: Denial Management Specialist
Location: Arlington Heights, IL
Full Time/Part Time: Full Time
Hours: Monday-Friday, standard business hours
Overview Reviews claim denials which pertain to medical necessity, pre-certification, authorization, and level of care requirements. This involves interaction with Physician Practices, Providers and Payers.
Responsibilities
Reviews and resolves denied patient insurance claims.
Works closely with internal departments in determining accurate denial and process for appeal. Contacts insurance companies/payer or patients to gather information necessary to complete the appeal process.
Sends appeals to insurance companies regarding denials by resubmitting corrected claim, submitting medical records and writing appeals letters in a timely manner.
Provides process improvement recommendations to Supervisor to decrease future denials.
Utilizes software tools to identify denial, trends and payer issues. Shares findings with stakeholders.
Follows up on pending claim denials after appeal has been processed – by the insurance company.
Collaborates in the collection of data and sends monthly "Managed Care Denial Report" to appropriate department Leaders including: Physician Coding Manager; Physician Billing Manager and Director, VP of EEH Physician Practices and Vice President of EEH Revenue Cycle.
Maintains positive working relationships both externally and internally.
Qualifications
Education:
High School Required
Experience:
2 Years previous patient billing or 2 Years managed care experience
Skills:
Extensive computer knowledge and experience. Knowledge of standard billing guidelines, CPT/ICD9 coding, usual and customary (U& C) schedules
Benefits
Career Pathways to Promote Professional Growth and Development
Various Medical, Dental, and Vision options
Tuition Reimbursement
Free Parking at designated locations
Wellness Program Savings Plan
Health Savings Account Options
Retirement Options with Company Match
Paid Time Off and Holiday Pay
Community Involvement Opportunities
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
#J-18808-Ljbffr