Denial Prevention Specialist

Flex Start time 6a-9a. 8 hour shift Must Reside in DWF, TX area. open to remote candidates in TX *MUST BE ABLE TO READ, WRITE, and SPEAK English fluently Physician Billing experience with ACTUALLY doing appeals 2 years recent experience in medical claims recovery and/or collections required This is primarily a remote position, however there are times the employee might have to come into the office for training, team building events or as requested by their supervisor or manager. JOB SUMMARY The successful candidate will review, research, and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effort to maximize collections. A successful candidate should have, but not be limited to the following skills: • Capable of reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed. • Contacting insurance carriers to check on the status of claims, appeals, and insurance verification. · Knowledgeable with payors including Managed Care, Commercial, Medicare, and Medicaid · Preparing/Submitting appeals related to denied services This is a work from home (WFH) opportunity. The successful applicant must live within the Greater DFW area and be available to come to the office for equipment pickup, office meetings, and training. Additional details regarding WFH will be discussed as part of the interview process. ESSENTIAL FUNCTIONS Job Duties • Analyze payer denials by denial groupers and submit appeals. • Contact patients and/or third party payers to resolve outstanding insurance balances and underpaid claims. • Make necessary adjustments as required by plan reimbursement. • Functions as a liaison between clinical departments and MSRDP management team. • Completes special projects as assigned. • Performs other duties as assigned. QUALIFICATIONS Education and Experience Required • Education High School Diploma or • Experience 2 years experience in medical claims recovery and/or collections required Preferred • Education Associate's Degree

salary: $23.63 - $23.64 per hour
shift: First
work hours: 6 AM - 4 PM
education: High School

Responsibilities

• Analyze payer denials by denial groupers and submit appeals.
• Contact patients and/or third party payers to resolve outstanding insurance balances and underpaid claims.
• Make necessary adjustments as required by plan reimbursement.
• Functions as a liaison between clinical departments and MSRDP management team.
• Completes special projects as assigned.
• Performs other duties as assigned.

Skills

• medical claims
• recovery
• collections

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

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Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

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