Denials Management Specialist

Hourly Pay Range $22.14 - $33.21 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors. Position Highlights Position: Denial Management Specialist Location: Warrenville IL Full Time/Part Time: Full Time Hours: Monday-Friday, 8am-4:30pm A Brief Overview Reviews claim denials which pertain to medical necessity, pre-certification, authorization, and level of care requirements. This involves interaction with physician practices, providers, and payers. What you will do Reviews and resolves denied patient insurance claims. Works closely with internal departments in determining accurate denial and process for appeal. Contacts insurance companies/payers or patients to gather information necessary to complete the appeal process. Sends appeals to insurance companies regarding denials by resubmitting corrected claim, submitting medical records and writing appeals letters in a timely manner. Provides process improvement recommendations to Supervisor to decrease future denials. Utilizes software tools to identify denial, trends and payer issues. Shares findings with stakeholders. Follows up on pending claim denials after appeal has been processed -by the insurance company. Collaborates in the collection of data and sends monthly "Managed Care Denial Report" to appropriate department leaders including: Physician Coding Manager; Physician Billing Manager and Director, VP of EEH Physician Practices and Vice President of EEH Revenue Cycle. Maintains positive working relationships both externally and internally. What you will need Education: High School Required Experience: 2 Years previous patient billing or 2 Years managed care experience Skills: Extensive computer knowledge and experience. Knowledge of standard billing guidelines, CPT/ICD9 coding, usual and customary (U& C) schedules Benefits (For full time or part time positions) Eligibility for our Annual Incentive Plan, which offers the potential to earn a certain percentage amount of your base salary based on organizational performance. Premium pay such as shift, on call, holiday and more based on an employee's job. Incentive pay for select positions. Opportunity for annual increases based on performance. Career Pathways to Promote Professional Growth and Development. Various Medical, Dental, Pet and Vision options. Tuition Reimbursement. Free Parking. Wellness Program Savings Plan. Health Savings Account Options. Retirement Options with Company Match. Paid Time Off and Holiday Pay. Community Involvement Opportunities. EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor. #J-18808-Ljbffr NorthShore University HealthSystem