Specialist-Denials Management (Remote)
Spartanburg Regional Medical CenterSpartanburg, SC
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Overview
Schedule
Full-time
Education
Medical Coding (CCA, CCS, CCS-P, CPC)
Career level
Senior-level
Remote
On-site
Job Description
Job Requirements
Position Summary
The Denial Management Specialist is responsible for denial and AR management for the department as defined by their supervisor/manager.
- Only Applicants from the following states: Alabama, Arizona, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia, Wisconsin.
Minimum Requirements
Education
- High School Diploma or equivalency
Experience
- 4 years' experience in medical billing, setting with exposure to denials, appeals, insurance collections and related follow-up.
- Must have good knowledge of ICD9 and CPT-4 coding
- Must have a good working knowledge with insurance explanation of benefits (EOB) and comprehensive understanding of remittance and remark codes.
- Be familiar with multiple payer requirements for claims processing
- Solid skills with Microsoft office with a focus on Excel and Word.
- Good Communication Skills
License/Registration/Certifications
- N/A
Preferred Requirements
Preferred Education
- Associates or Bachelor's degree in a Healthcare related field.
Preferred Experience
- Focused denials and appeals management experience.
Preferred License/Registration/Certifications
- CPC and/or CPC-H certification
Core Job Responsibilities
- Research and resolve all outstanding denials within workque and complete all necessary follow up within a timely and accurate manner
- Identify all denial trends and provide education of steps to prevent future avoidable denials.
- Initiate/manage all insurance appeals in a timely manner
- Manage outstanding AR related to denials.
- Communicate all denial trends and denial increases to direct supervisor/manager in order to positively affect the volume of denials
- Organize the workflow to ensure that denials are worked according to departmental policy and standards.
- Manage correspondences and any ADR requests as defined within department workflow procedure to ensure timeless and accuracy of response.
- Complete special projects as assigned by Supervisor/Manager
- Prepare/attend AR denial meetings as required.
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FAQs About Specialist-Denials Management (Remote) Jobs at Spartanburg Regional Medical Center
What is the work location for this position at Spartanburg Regional Medical Center?
This job at Spartanburg Regional Medical Center is located in Spartanburg, SC, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at Spartanburg Regional Medical Center?
Employer has not shared pay details for this role.
What employment applies to this position at Spartanburg Regional Medical Center?
Spartanburg Regional Medical Center lists this role as a Full-time position.
What experience level is required for this role at Spartanburg Regional Medical Center?
Spartanburg Regional Medical Center is looking for a candidate with "Senior-level" experience level.
What education level is required for this job?
The education requirement for this position is Medical Coding (CCA, CCS, CCS-P, CPC). Candidates with relevant qualifications or equivalent experience may also be considered.
What is the process to apply for this position at Spartanburg Regional Medical Center?
You can apply for this role at Spartanburg Regional Medical Center either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.