Rejection and Denial Specialist (Remote)

Melville,NY - USA

Position Requirements

PRIMARY RESPONSIBILITIES :

• Analyzes patient insurance to identify the correct insurance plan(s) was selected by reviewing the plan selection and any necessary documents or payor portals. Accurately documents all the proper steps to ensure accounts are worked correctly in a timely manner. Has the able to troubleshoot and resolve issues before they occur by collecting all the appropriate information to create useful error output
• Identifies billing errors and charge correction errors through research to resolve claim errors in a timely manner for the more complex eligibility tasks. This could include contacting payers, referring office / hospital, or patients to obtain medical insurance information.
• Follow the department directions, TIP sheets, procedure manuals, and departmental policy and procedures.
• Evaluate insurance payor set up with the billing system to confirm the eligibility payor connection logic. Assist management in optimizing the efficiency and quality of eligibility team.
• Assist with training and educating new and established staff members

QUALIFICATIONS REQUIRED QUALIFICATIONS :

DESIRED / PREFERRED QUALIFICATIONS :

3 plus years of denials management experience

Total Rewards

The Rejections and Denials Specialist will be responsible to work the denied eligibility claims for all assigned payers and states. This will include working within multiple work queues, contact payers online or by phone, updating accounts as needed, and identifying carrier-related denial trends. This position will need to maintain a thorough knowledge and understanding of all charge corrections and FSC transfers, on top of understanding the differences. Familiarity with anesthesia modifiers, procedure codes and diagnostic codes. In addition, there may be projects that may require a manual process by reviewing and working off spreadsheets.

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.