CPC Certified Denials Specialist

Job Summary

A company is looking for a Denial Management Specialist.

Key Responsibilities

• Review and resolve daily claim scrubber edits based on coding/billing guidelines
• Research and resolve outstanding denials and manage insurance appeals in a timely manner
• Identify denial trends and provide education to prevent future denials

Required Qualifications, Training, and Education

• High School Graduate with some college education
• 5+ years of experience in medical billing/collections with a focus on denials and appeals
• Extensive knowledge of ICD9 and CPT-4 coding and modifiers
• Familiarity with insurance explanation of benefits (EOB) and claims processing requirements
• CPC certification for Professional Billing Services or CRCA/CPC-H certification for Hospital Billing Services