TPL Denials Management Analyst
Accenture•Austin, TX
•$21 - $48•Hybrid
About The Position
The TPL Denials Management Specialist reviews denials from insurance carriers to determine if denial is valid. Identifies recovery opportunities and communicates with carriers to verify coverage, inquire about claim status and educate carriers about Medicaid rules.
Requirements
- Minimum 2 years of experience working in medical claims
Nice To Haves
- Microsoft 360
- Medicaid experience
- Medical billing experience
- Third Party Liability experience
Responsibilities
- Reviews explanation of benefits (EOB) from insurance carriers
- Analyzes claims to determine if the denial reason is valid or invalid
- Contacts insurance carriers to verify insurance coverage and claim status
- Contacts Medicaid providers to request claim information and/or medical records
- Communicates with insurance carriers regarding invalid denials
- Re-submits claims to carriers
- Performs follow-up to ensure claims are paid
- Actively participates in the development and documentation of work plans and associated procedures
- Works with other departments to coordinate TPL related processes
- Performs other duties as assigned
Benefits
- medical
- dental
- vision
- life
- long-term disability coverage
- 401(k) plan
- bonus opportunities
- paid holidays
- paid time off
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
