Job Summary

A healthcare consulting company is seeking a Telecommute Clinical Denials Specialist.

Individual must be able to fulfill the following responsibilities:

• Review denied claims and prepare responses to denials
• Conduct follow-up with claims that have been appealed or resolved
• Communicate with third party payers to facilitate reimbursements

Required Skills:

• Knowledge of  Federal, State and commercial insurance regulations, etc.
• Case management and chart review/audit experience
• Knowledge of clinical operations, charge creation, processing and reconciliation
• Knowledge of industry standard coding and billing methodologies
• Knowledge and understanding of CPT/HCPCS and ICD-10 codes, UB04 and CMS 1500
• Exceptional written, verbal and interpersonal communication skills