Denial Management Clerk

Med Metrix•Garden City, NY

About The Position

The Denials Management Clerk supports the Denial Management Department in the denials process for client hospitals. In this role, the Denials Management Clerk gathers and disseminates information from hospitals, physicians, and insurance companies pertaining to referred claims denied.

Requirements

High School Diploma or equivalent
Must be courteous and possess a strong work ethic, with the ability to work in a fast-paced environment
Proficient in Microsoft Office applications
Have strong organization and time-management skills
Ability to learn proprietary databases and systems, gAIge, Epic, Eagle, Epremis, Medi-Tech
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required

Responsibilities

Manually enter new cases referred from clients into database as needed
Update database with information gathered from correspondence
Set follow-up reminders in Outlook
Review daily reports for updates and due dates
Send updates on document requests received throughout the day
Send documentation to insurance carriers via portals, email, mail or fax
Work within gAIge to update daily tasks assigned on work queue
Log into all hospital applications and insurance carrier portals every two weeks
Submit appeals, correspondence, and medical records via carrier portals
Scan and label correspondence received daily via mail, email, or fax
Navigate hospital applications to obtain balances, charges, and UB documents
Download reports from portals for updates
Assist with the outgoing mail process
Scan documents into database
Assist patients with questions related to statuses of their accounts
Other duties as assigned
Use, protect, and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties