Electronic Denials Specialist

Ovation Healthcare Research • Newport, KY

441d

About The Position

The Electronic Denials Specialist at Ovation Healthcare is responsible for managing and resolving electronic claim denials received through the claims clearing house. This role focuses on correcting errors that lead to claim rejections at the EDI level, ensuring efficient processing and resubmission of claims to support independent healthcare providers.

Requirements

• Experience with Electronic Data Interchange (EDI) processes.
• Mid-level experience in healthcare billing and claims management.
• Strong analytical skills to identify denial trends.

Nice To Haves

• Knowledge of healthcare regulations and compliance standards.
• Experience with claims clearinghouse systems.

Responsibilities

• Correct and resubmit claims in the clearinghouse portal and billing system.
• Direct rejected claims to other departments for resolution if warranted.
• Identify denial trends and report to lead for review to assist in preventing future denials.
• Open cases and work directly with the clearinghouse when claim rejections are being received in error.

Benefits

• Competitive salary range of $41.7K - $52.7K per year.
• Opportunity to work in a collaborative and professional environment.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed