Denial Management Specialist- Physician

Northside Hospital•Atlanta, GA

2d•Onsite

About The Position

Northside Hospital is an award-winning, state-of-the-art, and continually growing healthcare provider. This position offers an opportunity to contribute to the quality and reach of care for patients and communities. The Denial Management Specialist is responsible for following up on unprocessed or denied insurance claims through extensive communication with payors and pricing agencies. This role involves working with physician offices and billing office employees to resolve outstanding claim issues, ensuring correct reimbursement rates based on current client contracts, and utilizing knowledge of the revenue cycle and patient accounts to maximize reimbursements. The specialist must also abide by and promote HIPAA compliance at all times.

Requirements

1 year insurance collections/ AR receivables experience or 2 years of customer service/ banking/ accounting experience
Good verbal and written communication skills.
Basic computer skills, including the Microsoft Office Suite
Basic reading, writing, and arithmetic skills

Nice To Haves

Knowledge of healthcare receivables and collections, including denial and appeal processes.
Understanding of the healthcare revenue cycle
Coding knowledge or CPC certification
Knowledge and ability to use insurance company websites

Responsibilities

Follows up on unprocessed or denied insurance claims through extensive phone, fax, and written correspondence with payors and pricing agencies.
Works with physician offices and billing office employees to resolve any outstanding claim issues.
Ensures correct reimbursement rates are paid on claims based on current client contracts.
Utilizes knowledge of the revenue cycle and patient accounts to maximize reimbursements.
Abides by and promotes HIPAA compliance at all times.

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