Coordinator, Denials Management

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

📋 Description

• Distinguish between clinical and technical denials by analyzing EOBs, denial letters, payer correspondence, and conducting data mining.

• Examine UB04 and/or HCFA 1500 forms thoroughly.

• Assess timely filing guidelines in relation to the appeals process.

• Communicate with payers via phone to negotiate resolutions for technical denials.

• Challenge denials by utilizing appeal letters, medical records, supporting documents, and collaborating with on-staff clinicians.

• Analyze appeal outcomes, document recovered funds, support upheld decisions, or initiate second-level appeals when necessary.

• Oversee assigned account workload through prompt follow-up and precise record maintenance.

• Perform duties at a computer terminal for 6-8 hours daily while managing interruptions and multiple deadlines.

⛳️ Requirements

• A four-year degree is preferred or equivalent experience in hospital-related billing and follow-up fields.

• Familiarity with or experience in working with managed care contracts.

• Background in customer support or client issue resolution management is required.

• Strong analytical skills are essential.

• Excellent communication skills are necessary.

• Ability to multi-task effectively.

• Proficiency in MS Office is expected.

• Must be available to work Monday through Friday, from 8:00 AM to 5:00 PM EST.

• Remote work is limited to candidates within the US only.

• Capability to work at a computer terminal for 6-8 hours a day is required.

• Must be able to lift and move materials weighing up to 20 lbs. on an infrequent basis.

🏝️ Benefits

• Medical, Dental, and Vision Insurance.

• Equipment provided for remote work.

• 401k matching up to 2%.

• Paid Time Off (PTO) of 80 hours accrued annually.

• Nine paid holidays each year.

• Tuition reimbursement available.

• Opportunities for professional growth and more!