Denials Specialist

Midwest Vision Partners•,

About The Position

The Denials Specialist is responsible for following up on and collecting accounts receivable, including general payer collections and denial follow-up. The role may also oversee intake of patient calls and performs accounting, customer service, and organizational tasks that support the organization’s financial health. Duties listed are not exhaustive, and other related work may be assigned.

Requirements

High school diploma or equivalent.
Previous healthcare experience in Accounts Receivable Management.
Ability to read various EOBs.
Knowledge of payer portals.
Knowledge of Medicare and Medicaid.

Nice To Haves

Excellent written and verbal communication skills.
Excellent computer skills, including Excel, Word, and RCM systems as needed.
Strong organization, attention to detail, work ethic, and teamwork skills.
Ability to multitask and meet deadlines.

Responsibilities

Follow up on accounts receivable, including collections and denial resolution.
Call payers directly and use payer portals.
Work with patient account systems, work queues, and Excel documents.
Resolve credit balances.
Interpret Explanation of Benefits (EOBs) to reconcile patient accounts, determine balances, and identify actions such as refunds or takebacks.
Call insurance companies to resolve outstanding claims and balances.
Identify trends and communicate payer scenarios.
Perform month-end close procedures within established time frames.
Communicate payer and account issues to management in a timely manner.
Monitor accounts for other payment opportunities, including copays, deductibles, and coinsurance.
Enter clear and concise comments in the software system for tracking and documentation.
Adhere to HIPAA standards and other privacy and compliance policies.
Stay informed about payer and contract updates and bulletins.
Perform other duties as assigned to support the organization’s financial health.