Billing Denials Management Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct thorough investigations and promptly resolve all assigned insurance claim denials.

• Analyze denial patterns to uncover root causes by payer, provider, or service type.

• Create, document, and implement standard operating procedures for addressing common denial issues.

• Prepare and submit persuasive appeals to insurance companies, ensuring all necessary documentation is included.

• Collaborate with the coding team and clinical personnel to gather corrected information or documentation for claim resubmission.

• Monitor and report on denial statuses, recovery rates, and the financial implications of denial trends.

• Stay updated on payer policies, billing regulations, and industry standards pertinent to medical billing and denials.

• Perform additional responsibilities as assigned related to revenue cycle management.

⛳️ Requirements

• At least 3 years of experience in a medical billing position with an emphasis on denials management, appeals, and collections.

• High school diploma or equivalent is required; an Associate's degree or relevant certification is advantageous.

• Demonstrated success in appealing and recovering denied claims.

• Experience in a laboratory or comparable outpatient environment is highly desirable.

• Knowledge of HIPAA regulations, the False Claims Act, and other healthcare compliance standards is essential.

🏝️ Benefits

• Paid leave: Sick, Annual, Public holidays

• New hires start as independent contractors for the first 6 months prior to eligibility for a review for full-time employment.