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 carriers
• Research and monitor unpaid or denied claims and secure necessary medical documentation
• Contact payers to secure payment of claims and submit reconsiderations or appeals

Required Qualifications

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