Medical Claims Denials Representative

Job Summary

Working remotely in a full-time capacity, the Provider Enrollment Denials Representative will review and resolve provider enrollment payment denials, utilizing various research tools and communicating necessary actions to correct issues.

Key responsibilities

• Monitor and review payment denials using the Enterprise Task Manager (ETM)
• Utilize telephone and carrier websites to expedite resolution of denied claims
• Assemble and forward documentation to the appeals department and senior analysts as needed

Required qualifications

• High school diploma or equivalent
• 1 - 3 years of experience in physician medical billing, focusing on research and claim denials
• Thorough knowledge of revenue cycle and healthcare reimbursement guidelines
• Intermediate computer literacy, particularly in Excel
• General knowledge of ICD and CPT coding