Denials Follow Up Representative

Job Summary

Working remotely in a full-time capacity, the Denials Follow Up Representative will manage denials by differentiating between clinical and technical issues, negotiating resolutions with payers, and evaluating appeal outcomes while maintaining accurate records.

Key responsibilities

• Differentiates between clinical and technical denials through EOBs, denial letters, and data mining
• Contacts payers to negotiate resolutions on technical denials and appeals using various documentation
• Manages assigned workload of accounts through timely follow-up and accurate record keeping

Required qualifications

• Four-year degree preferred or equivalent experience in hospital-related billing/follow-up field
• Knowledge of/experience working with managed care contracts
• Experience in customer support or client issue resolution management
• Strong analytical acumen and multi-tasking skills
• Proficiency with MS Office