Denial Management Specialist (Remote)

Job Description

• ESSENTIAL DUTIES AND RESPONSIBILITIES

• The Specialist will monitor assigned pools and duties in Artiva, HMS, Hyland, BARRT and other host systems and applications with currency to follow up dates.

• File appeals as needed to resolve payer denials and work with payers and monitor appeals in process. Properly track and document all denial and appeal activity.

• Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.

• Maintain BARRT requests (Outbound/Inbound) timely. Maintain all logs, account notes and system records as assigned.

• Review and work RAC/Government Audit accounts as needed. Monitor AB rebills that are needed on RAC accounts and post recovery or denial adjustments as needed

• Help identify issues from denials and appeals that might be avoided on future claims. Review and analyze all denial trends and issues as assigned.

QUALIFICATIONS

REQUIRED EDUCATION

• Diploma or Equivalent education

REQUIRED EXPERIENCE

• Minimum 1 year experience in healthcare setting with experience in medical terminology.

• Experience in revenue cycle processes in a hospital or physician office.

KNOWLEDGE, SKILLS, AND ABILITIES

• Intermediate knowledge of Microsoft Office tools and/or Google platforms