Patient Accounting Denials Specialist I

Presbyterian Healthcare Services

2d•$17 - $27•Onsite

About The Position

Presbyterian is hiring a skilled Patient Accounting Denials Specialist I- Business-Office Physician Services. 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.
Computer literate.
Must be passionate about being part of an organization focused on continuously improving patient experiences and the health of our community.
Excellent organizational, problem-solving, verbal, and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams are required.
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.
Must be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.

Nice To Haves

Experience with Microsoft Office Suite products preferred.
Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.)

Responsibilities

Perform denial follow-up activities for assigned payors utilizing work queues.
Submit corrected claims, reconsiderations and/or appeals to overturn denials.
Provide any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials.
Follow process/procedures to ensure timely follow up on outstanding denials.
Document accounts in accordance with established PHS policies/procedures.
Utilize communication skills to be an effective team member.
Actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns.
Develop and maintain professional work relationships with team members, PHS departments and outside agencies.
Maintain strictest confidentiality, adhere to all HIPAA and CMS compliance rules and regulations.