Denials Specialist

Job Summary

A company is looking for a Denials Specialist to manage and resolve claims denials and maximize reimbursement from contracted payers.

Key Responsibilities

• Evaluate and categorize denied accounts, identifying repetitive issues and preventative solutions
• Develop and maintain relationships with hospital departments and payers to facilitate successful appeals
• Research payer issues and track the status of appeals, ensuring compliance with established timelines

Required Qualifications

• Associate's degree in accounting, business office practices, computer science, or related area, 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
• Independently functions within scope of department policies and practices