Denials Specialist

Job Summary

A company is looking for a Denials Specialist to manage and analyze denials for optimal reimbursement from payers.

Key Responsibilities

• Evaluate and categorize denied accounts, identifying repetitive issues and ensuring timely resolution
• Develop and maintain relationships with hospital departments and payers to facilitate successful appeals
• Track and report on denial trends, ensuring compliance with regulations and internal policies

Required Qualifications

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