Healthcare Denials Specialist
Job Summary
Experienced in healthcare insurance reimbursement, the full-time remote Healthcare Denials Specialist will analyze and resolve payer denials and underpayments while mentoring junior representatives and utilizing advanced ARO software to streamline medical claims and collections.
Key responsibilities
- Manage and resolve moderately complicated insurance denials and underpayments using Rubixis AR Follow Up software
- Analyze contracts, billing, and collections to ensure compliance with regulations and investigate deviations in insurance payments
- Collaborate with leadership and team members to provide insights and solutions regarding payer issues
Required qualifications
- 5+ years of hospital billing experience with advanced knowledge of various payer types
- Expertise in Medicare payer rules and the ability to submit appeals and corrections using Medicare Direct Data Entry (DDE)
- Detailed understanding of insurance follow-up processes for healthcare providers
- Experience with UB04 Facility Pricing and Reimbursement variances
- Basic knowledge of HIT systems such as EPIC, Paragon, or Zirmed
Complete Job Description
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