* Drafts written letters of appeal on various types of denied claims utilizing standard letters as well as customized letters depending on the denial.
* Utilizes/reviews account information from various sources; online data, hard copy reports, referral forms, UB92/itemized bills, and EOBs to discuss account condition with the payer.
* Obtains information from Northside's contract summaries to negotiate reimbursement requirements of a claim.
* Refers accounts to appropriate departments for necessary action to be taken i.e., balance transfers, electronic billing of accounts, audit, and coding reviews, etc.
* Contacts insurance companies to follow up on appealed claims. Holds insurance company accountable for timely resolution of all appeals submitted.
* Maintains appropriate and accurate system documentation with notes and standard note codes allowing for appropriate extraction of denial data from the Denial database.
* Notifies Supervisor of payor trends in denied accounts.
* 3-5 years of experience within Hospital or Physician Denials
* High school diploma
* UB92/itemized bill experience
* EOB experience
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.