REMOTE Denials Management Specialist

Post Date

Mar 01, 2023

Location

Miami,
Florida

ZIP/Postal Code

33156
US
Dec 01, 2023 Insight Global

Job Type

Contract-to-perm

Category

Claims/Denials

Req #

HFL-606892

Job Description

- Provides Liaison between the providers of health care services, the patient, or other responsible persons, and revenue sources, to ensure the correctness of charges, a current record of all transactions, and account resolution

- Maintains active communications with insurance carriers and third-party carriers until account is paid.

- Negotiates payment of current and past due accounts by direct telephone and written correspondence.

- Updates patient account information.

- Monitors and identifies payer denial trends and problem accounts; communicates patterns to supervisor.

- Runs a monthly aging report based on DOS and current A/R to identify accounts that require follow up.

- Manage all assigned worklist daily for assigned insurances.

- Utilize collection techniques to resolve accounts according to company's policies and procedures.

- Report any coding related denial to the Coding Specialist.

- Performs other duties including but limited to faxing information as required, generating retroactive authorization requests, and verifying medical eligibility.

- Conducts necessary research to ensure proper reimbursement of claims.

Required Skills & Experience

- High School or GED

- Minimum 1+ years of medical insurance collections experience with commercial payors

o Commercial payors -- Aetna, Cigna, United Healthcare, Medicaid, the "blues" (BCBS, Anthem, etc.)

- Knowledge of medical terminology utilized in medical collections and billing (CPT, ICD-10, HCPCS)

- Experience with insurance claims and insurance denials

- Experience in payor portals and EHR systems (Availity, CignaforHCP, United Health Care)

Nice to Have Skills & Experience

- Experience in a gastro specialty

- Experience with eClinicalWorks

-Experience working with Washington insurance companies