Technical Denials Management Specialist II
Randstad USA, Dallas, TX, United States
Our client is seeking a detail-oriented and analytical Technical Denials Management Specialist II to join their Revenue Cycle Department. In this role, you will be responsible for reviewing, researching, and resolving claim denials and appeals across various insurance carriers. Your primary goal will be to identify payment trends and execute strategies to maximize collections.
This is a remote opportunity. However, candidates MUST RESIDE WITHIN the GREATER DFW AREA to facilitate equipment pickup, attend in-office meetings, and participate in on-site training as required.
salary: $20 - $22 per hour
shift: First
work hours: 8 AM - 5 PM
education: Associate
Responsibilities
Denial Analysis:
Analyze payer denials by denial groupers and submit comprehensive appeals to secure reimbursement.
Claim Resolution:
Contact patients and third-party payers to resolve outstanding insurance balances and underpaid claims.
Payer Navigation:
Review Explanations of Benefits (EOBs) to determine claim processing logic and contact carriers for status updates on claims, appeals, and insurance verification.
Financial Adjustments:
Process necessary financial adjustments as required by specific plan reimbursement guidelines.
Interdepartmental Liaison:
Serve as a key point of contact between clinical departments and the management team.
Trend Identification:
Monitor and report on payer trends involving Managed Care, Commercial, Medicare, and Medicaid.
Skills
Medical Billing - Denials
Verbal Communication
Analytical Thinking
Denial Management
Revenue Cycle
HIPAA
Medicare/Medicaid
Qualifications
Years of experience: 3 years
Experience level: Experienced
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
Experience
Experienced
3 years
Education
Associates (required)
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This is a remote opportunity. However, candidates MUST RESIDE WITHIN the GREATER DFW AREA to facilitate equipment pickup, attend in-office meetings, and participate in on-site training as required.
salary: $20 - $22 per hour
shift: First
work hours: 8 AM - 5 PM
education: Associate
Responsibilities
Denial Analysis:
Analyze payer denials by denial groupers and submit comprehensive appeals to secure reimbursement.
Claim Resolution:
Contact patients and third-party payers to resolve outstanding insurance balances and underpaid claims.
Payer Navigation:
Review Explanations of Benefits (EOBs) to determine claim processing logic and contact carriers for status updates on claims, appeals, and insurance verification.
Financial Adjustments:
Process necessary financial adjustments as required by specific plan reimbursement guidelines.
Interdepartmental Liaison:
Serve as a key point of contact between clinical departments and the management team.
Trend Identification:
Monitor and report on payer trends involving Managed Care, Commercial, Medicare, and Medicaid.
Skills
Medical Billing - Denials
Verbal Communication
Analytical Thinking
Denial Management
Revenue Cycle
HIPAA
Medicare/Medicaid
Qualifications
Years of experience: 3 years
Experience level: Experienced
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
Experience
Experienced
3 years
Education
Associates (required)
#J-18808-Ljbffr