Denials Specialist

Job not on LinkedIn

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Medsuite Inc

WebsiteLinkedInAll Job Openings

1 - 10 employees

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare Insurance • SaaS • HealthTech

Medsuite Inc. is a digital platform designed to streamline healthcare management and improve patient care. It provides tools for healthcare providers to manage patient records, appointments, and communications efficiently, all while prioritizing user-friendly access for patients and providers alike.

📋 Description

• Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques • Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides • Validate denial reasons and ensures coding is accurate • Generate an appeal based on the dispute reason and contract terms specific to the payor • Follow specific payer guidelines for appeals submission • Escalate exhausted appeal efforts for resolution • Adhere to departmental production and quality standards • Complete special projects as assigned by management • Maintain working knowledge of workflow, systems, and tools used in the department

🎯 Requirements

• High school diploma or equivalent • One to three years’ experience in physician medical billing with emphasis on research and claim denials • Current AAPC or AHIMA certification required • Knowledge of health insurance, including coding • Thorough knowledge of physician billing policies and procedures • Thorough knowledge of healthcare reimbursement guidelines • Knowledge of AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding • Computer literate, working knowledge of Excel helpful • Good organizational and analytical skills • Ability to work independently • Proficient computer skills, with the ability to learn applicable internal systems • Strong oral, written, and interpersonal communication skills • Strong time management and organizational skills

🏖️ Benefits

• Health insurance • 401(k) matching • Performance-based incentive plan • Referral bonus