Denial Management Specialist / Remote

Our Company

Amerita

Overview

Are you a numbers aficionado, skillful in maximizing costs and minimizing expenses Finance and Accounting focuses on the organization's financial management strategies and execution. If this piques your interest, read more below and apply today!

Shift: Monday-Friday 8:00am-4:30pm

Responsibilities

Reviews and researches claims in which a denial payment has been received from the payer in a timely manner

Manages and Develops necessary department and executive level reporting

Identifies the root cause of the denial and addresses the denial issue with the appropriate department (Billing, Clinical Documentation, Coding)

Utilizes all appreciate systems to effectively research claims and complete steps to submit information necessary to process or appeal claims

Investigates and ensures that questions and requests for information are responded to in a timely and professional manner to ensure resolution of outstanding claims

Completes and requests adjustments to a claim, as appropriate, based on the dollar threshold of the adjustment

Reviews, works and reports all claims that have aged more than the specified grace period stipulated in policies and/or contacts

Organizes work/ resources to accomplish objectives and meet deadlines

Demonstrates problem- solving skills related to denial analysis

Demonstrates the willingness and ability to work collaboratively with other key internal and external staff, both clinically and administratively to obtain necessary information to address denial management issues

Meets productivity requirements to ensure excellent service is provided to customers

Maintains compliance with established corporate and departmental policies and procedures

Maintains stable performance under pressure and handles stress in ways to maintain relationships with patients, customers and co-workers

Identify all denial trends and provide education of steps to prevent future avoidable denials

Initiate/Manage all appeals in a timely manner

Organize the work flow to ensure that denials are worked according to timely filing deadlines and conditions of payment

Communicate all denial trends and denial increases to direct supervisor in order to positively affect the volume of denials

Building relationships with payors

Complete special projects as assigned by Supervisor/Manager

Qualifications

High School Diploma required; Bachelors Degree preferred

At least three to five years of experience in revenue cycle and/or billing experience

Denial Management and/or electronic billing experience are preferred

Highly motivated individual with attention to detail in fast paced environment

Good internal/external customer communication skills required

Able to work independently and collaboratively as a team player

Systems include Excel, Power Point, Zirmed billing system

About our Line of Business

Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit [hidden] Follow us on Facebook, LinkedIn, and X.

Salary Range

USD $18.00 - $22.00 / Hour

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