Denials Management Specialist

Job Summary

Denials Management Specialist, a full-time position, is responsible for maximizing reimbursement from contracted payers through analysis and management of denials, executing the appeal process, and collaborating with various departments to resolve issues.

Key Responsibilities

• Evaluate denied accounts and assign them for resolution while identifying repetitive issues
• Maintain relationships with hospital departments and payers to facilitate successful appeals and resolve denials
• Track the status of appeals and maintain organized records to ensure compliance with established timelines

Required Qualifications

• Associate's degree in accounting, business office practices, or related field, or equivalent experience
• Three to five years of experience in hospital patient accounting
• Thorough knowledge of claims administration and familiarity with ICD-9/10, CPT-4 coding, UB04, and HCFA 1500 claims
• Ability to perform financial analysis and knowledge of regulatory requirements
• Ability to function independently within departmental policies and practices