Claims - Patient Accounting Denials Specialist

Presbyterian Healthcare Services • Remote Workers New Mexico, NM

5d • $17 - $27 • Remote

About The Position

The Patient Accounting Denials Specialist I performs root cause analysis and determines next steps to resolve denials. The role includes accounts receivable follow-up, appeals, customer service, correspondence processing, and daily reconciliation of activities. This is a full-time, non-exempt remote position for workers in New Mexico, with a day shift.

Requirements

• High school degree or GED.
• Short-term training in insurance collections and claims processing.
• At least two years of experience in insurance follow-up, billing, and collections.
• Ability to communicate effectively by telephone and in writing.
• Computer literacy.
• Passion for contributing to an organization focused on improving patient experiences and community health.
• Strong work ethic and ability to work effectively in a team environment.
• Ability to prioritize and manage a high-volume workload in a fast-paced environment while adapting to changing payer regulations and requirements.

Responsibilities

• Perform denial follow-up for assigned payors using work queues.
• Submit corrected claims, reconsiderations, and appeals to overturn denials.
• Provide insurance companies with requested information, such as medical records and itemized statements, to process claims and overturn denials.
• Follow established processes and procedures to ensure timely follow-up on outstanding denials.
• Document accounts in accordance with established PHS policies and procedures.
• Use relevant computer systems, including electronic health records, claims clearinghouses, FISS/DDE, payer portals, and Microsoft Office.
• Use communication skills to contribute effectively as a team member.
• Participate actively in team meetings and proactively communicate work-related ideas and concerns.
• Develop and maintain professional working relationships with team members, PHS departments, and outside agencies.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Short-term disability insurance
• Long-term disability insurance
• Group term life insurance
• Optional voluntary benefits
• Employee wellness rewards program, with opportunities to earn gift cards and other rewards

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED