Denials Specialist

Meadville Medical Center•Meadville, PA

About The Position

JOB DUTIES Complete medical records requests for pre and post payment audits in accordance with company policies and procedure in a timely manner while meeting or exceeding production and quality standards. Attend appeals meetings to document back end appeals in order to follow up. Position is responsible for submission of disputes to CMS against MA plans. Complete special denial investigations as assigned. Ability to communicate with other departments, payors, and outside agencies through telephone, electronic and written correspondence. Maintains strict confidentially of patient information. Gather and compile information necessary to perform appeals on denied claims. Effectively prioritize and complete all assigned tasks. Must be multi-disciplined in billing, collections, denials, credit balances and or the various payors. Performs other duties as assigned. MINIMUM EDUCATION, KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED High school diploma or equivalent. Minimum one year experience with medical records. Knowledge of various payer groups. Ability to work in high production environment. Position requires excellent customer service. Position requires attention to detail and ability to work in a fast-paced team environment. Strong verbal and written communication skills. Familiarity with Microsoft application (including but not limited to word and excel). This role requires extensive computer use. General knowledge of internet navigation and research, email, fax transmission, scanning and copy equipment.

Requirements

High school diploma or equivalent.
Minimum one year experience with medical records.
Knowledge of various payer groups.
Ability to work in high production environment.
Position requires excellent customer service.
Position requires attention to detail and ability to work in a fast-paced team environment.
Strong verbal and written communication skills.
Familiarity with Microsoft application (including but not limited to word and excel).
This role requires extensive computer use.
General knowledge of internet navigation and research, email, fax transmission, scanning and copy equipment.

Responsibilities

Complete medical records requests for pre and post payment audits in accordance with company policies and procedure in a timely manner while meeting or exceeding production and quality standards.
Attend appeals meetings to document back end appeals in order to follow up.
Position is responsible for submission of disputes to CMS against MA plans.
Complete special denial investigations as assigned.
Ability to communicate with other departments, payors, and outside agencies through telephone, electronic and written correspondence.
Maintains strict confidentially of patient information.
Gather and compile information necessary to perform appeals on denied claims.
Effectively prioritize and complete all assigned tasks.
Must be multi-disciplined in billing, collections, denials, credit balances and or the various payors.
Performs other duties as assigned.