Billing Denials Management Specialist

🔥 1 hour ago

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RMLPH

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2024

RML-PH is a dynamic and innovative Health Solutions and Care Delivery Organization committed to transforming the healthcare landscape. With a mission to provide accessible, high-quality healthcare services and cutting-edge solutions, RML-PH focuses on holistic patient care and embraces the latest advancements in health technology. Our team is dedicated to providing top-tier customer care, leveraging expertise and technology to exceed expectations. Join us at RML-PH to be part of a dynamic team committed to delivering excellence in healthcare customer service.

📋 Description

• Investigate and resolve all assigned insurance claim denials in a timely and efficient manner. • Analyze denial trends to identify root causes and patterns by payer, provider, or service type. • Develop, document, and implement standard operating procedures for resolving common denial reasons. • Prepare and submit compelling appeals to insurance companies with all necessary documentation. • Collaborate with the coding team and clinical staff to obtain corrected information or documentation for claim resubmission. • Track and report on denial statuses, recovery rates, and the financial impact of denial trends. • Maintain up-to-date knowledge of payer policies, billing regulations, and industry standards related to medical billing and denials. • Perform other duties as assigned related to revenue cycle management.

🎯 Requirements

• Minimum of 3 years of experience in a medical billing role with a focus on denials management, appeals, and collections. • High school diploma or equivalent required; Associate's degree or relevant certification is a plus. • Proven track record of successfully appealing and recovering denied claims. • Experience in a laboratory or similar outpatient setting is highly preferred. • Familiarity with HIPAA regulations, the False Claims Act, and other healthcare compliance standards.

🏖️ Benefits

• Paid leave: Sick, Annual, Public holidays • New Hires begin as independent contractors for the first 6 months before they are eligible for a review for full-time employment