Denials Management Specialist

Park Dental • Minneapolis, MN

449d

About The Position

The Denials Management Specialist at Park Dental is responsible for analyzing claims data, resolving payer issues, and facilitating training for team members. This role requires strong communication skills and the ability to manage multiple tasks efficiently while ensuring effective collaboration with various stakeholders. The position plays a crucial role in improving workflow processes and enhancing the overall revenue cycle management.

Requirements

• Strong interpersonal and communication skills.
• Ability to confidently interact with and lead peers to achieve results and/or effect changes.
• Ability to be persuasive and capable of developing and presenting a business rationale for proposed changes or actions.
• Ability to manage multiple deliverables simultaneously, accurately and efficiently with minimal direction.
• Exceptional written and verbal communication skills with the ability to communicate highly complex insurance and claim information to patients and internal stakeholders at all levels in the organization.
• Previous experience interpreting a variety of payers' explanation of benefits, reimbursement models and claim adjudication processes.
• Experience analyzing large amounts of dynamic data to identify trends and aberrations.

Nice To Haves

• Bachelor's degree in related field preferred.
• Dental denials management/billing experience.
• Familiarity with Dental and Medical insurance claims.
• Experience with verbal and written communication to healthcare professionals and patients.

Responsibilities

• Analyzes claims data for trends and exceptions, including team email inbox inquiries, status reports, daily claim batch submission, and the clearinghouse portal.
• Researches and resolves or provides recommendations for payer, provider or processing issues.
• Maintains effective communication with practices, revenue cycle teams and other Resource departments to provide clarification and progress updates of outstanding issues.
• Facilitates training and coaching for new and existing team members including updating workflows, developing curriculum, and creating job aids.
• Performs periodic audits of claims submitted and other processes.
• Proactively develops or assists with workflow design improvements, and execution of pilot programs, projects and quality initiatives.
• Works open insurance claims to ensure prompt processing.
• Reads and interprets payer explanation of benefits and verifies claim adjudication in accordance with contract guidelines.
• Appeals and follows up on denied insurance claims.
• Resolves electronic claim rejections.
• Creates, updates and maintains insurance plans for billing in practice management system.
• Submits pre and retro authorization requests for planned and rendered services.

Benefits

• Competitive compensation
• Medical insurance
• Vision insurance
• Dental insurance
• Paid time off (PTO)
• Holiday pay
• 401k matching
• Continuing education opportunities

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees