Patient Accounting Denials Specialist I

Presbyterian Healthcare Services•Remote Workers New Mexico, NM

8d•$16 - $23•Remote

About The Position

Presbyterian is hiring a skilled Patient Accounting Denials Specialist I. This role is responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A/R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activities.

Requirements

High school degree or GED required
Short-term training on insurance collections and claims processing.
Minimum two years experience in insurance follow-up, billing, and collections.
Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.
Must be passionate about being part of an organization focused on continuously improving patient experiences and the health of our community.
Must have a strong work ethic and demonstrated ability to work effectively in a team environment.
Must be able to prioritize and manage a high-volume workload and be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.

Responsibilities

Performs denial follow-up activities for assigned payors utilizing work queues.
Submits corrected claims, reconsiderations and/or appeals to overturn denials.
Responsible for providing any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials.
Must follow process/procedures to ensure timely follow up on outstanding denials.
Document accounts in accordance with established PHS policies/procedures.
Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.)
Must utilize communication skills to be an effective team member.
Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns.
Must develop and maintain professional work relationships with team members, PHS departments and outside agencies.