Denial Reimburse Specialist

Franciscan Alliance, Inc.

1d•Remote

About The Position

Some people love getting to the bottom of things -- chasing down denied claims, resolving accounts, digging through the details to identify discrepancies and needs. Yes, we’re talking about people who love collections. And it takes a love of getting into the details to do this job well. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

Requirements

High School Diploma/GED
2 years Revenue Cycle with strong AR account follow-up, appeals, billing and/or coding knowledge OR Insurance Verification/Patient Accounting

Nice To Haves

Associate's Degree

Responsibilities

Conduct inquiries via phone, mail, fax, or electronically to conduct follow-up on the accounts that have not been denied and resubmitted for payment.
Conduct follow-up with insurance carriers, physicians, and other stakeholders that can validate and assist with actions and information needed in order to properly review, dispute or appeal denial until a determination is made to conclude the appeal.
Resubmit overturned denials as warranted and monitor denial resubmissions for payment; resubmit claims using the denial program re-bill requests feature, ensuring all modifications to the account are reflected on the claim form.
Ensure information sent to insurance carriers have all release of information necessary and is HIPPA compliant.
Analyze reports and use software to track, trend and identify root causes of denials; offer suggestions for process improvement to resolve denial issues, supported by documentation and data.
Review denials and payment discrepancies identified through the denial system, which are directly related to the verification, authorization and registration process.
Prepare and submit patient record requests from care delivery sites and provide correspondence to patient on requested information.