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Medical Denials/Collections Specialist

HR Solutions Careers

Medical Denials/Collections Specialist

Baton Rouge, LA
Full Time
Paid
  • Responsibilities

    DUTIES

    • Researches and analyzes denial data and coordinate denial recovery responsibilities.

    • Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of denials

    • Develop reporting tools that effectively measure and monitor processes throughout the denials management process in order to support process improvement.

    • Prioritizes activities to work overturns in a timely manner to alleviate untimely filings

    • Uses reports that categorize denials to assign tasks or personally work to overturn denials

    • Identifies and pursues opportunities for improvements in denial performance

    • Processes work lists to facilitate prompt intervention of insurance denials

    • Researches, responds, and documents insurer and patient correspondence/inquiry notes regarding coding coverage, benefits, and reimbursement on patient accounts

    • Researches rejections included in EOBs for resolution and files appropriately

    • Makes management aware of any issues or changes in the billing system, insurance carriers, and/or networks

    • Helps with coverage for the Financial Counselor.

    QUALIFICATIONS 

    • Demonstrated understanding of medical terminology required • Knowledge of patient confidentiality and HIPAA regulations • Knowledge of CPT, HCPCS, and ICD10 coding required. • Knowledge of medical billing and collection practices • Understands Medicare and Medical Assistance regulations as they apply to job functions • Knowledge working with electronic health records (EHR/EMR) or healthcare related computer systems • Excellent written and verbal skills are required as well as outstanding interpersonal skills • Practices efficient methods for getting work done; strong ability to prioritize workload • Organized; sets priorities; meets deadlines • Ability to work independently.