Denials Management Specialist

Job Summary

A company is looking for a Denials Specialist to manage and analyze claims denials and appeals.

Key Responsibilities

• Evaluate and categorize denied accounts for appropriate resolution and identify repetitive issues
• Develop and maintain relationships with hospital departments and payers to facilitate successful appeals
• Track and maintain organized records of appeals to ensure compliance with established timelines

Required Qualifications

• Associate's degree in accounting, business office practices, computer science, or a related area, or equivalent experience
• Three to five years of experience in hospital patient accounting
• Thorough knowledge of claims administration in a complex healthcare organization
• Familiarity with ICD-9/10, CPT-4 coding, UB04, and HCFA 1500 claims administration
• Comprehensive knowledge of patient accounting activities in an automated, networked hospital environment