Complex Denials Specialist

Job Summary

A company is looking for a Complex Denials Specialist, Accounts Receivable.

Key Responsibilities

• Verify and obtain eligibility and authorization from insurance providers
• Research and monitor unpaid or denied claims and contact payers for payment resolution
• Maintain patient confidentiality and perform related duties as required

Required Qualifications

• 2-3 years of experience in medical collections, denials, and appeals
• Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI
• Familiarity with billing claim forms (UB04/1500) and third-party billing guidelines
• Experience with health information systems and Microsoft Word and Excel
• Understanding of payor contracts, both commercial and government