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 related to medical necessity, pre-certification, authorization, and level of care requirements. This involves interaction with physician practices, providers, and payers. What you will do: Review and resolve denied patient insurance claims. Work closely with internal departments to determine accurate denial process for appeal; contact insurance companies/payers or patients to gather necessary information to complete appeals. Send appeals to insurance companies regarding denials by resubmitting corrected claims, submitting medical records, and writing appeal letters in a timely manner. Provide process improvement recommendations to the supervisor to decrease future denials. Utilize software tools to identify denial trends and payer issues; share findings with stakeholders. Follow up on pending claim denials after the appeal has been processed by the insurance company. Collaborate in the collection of data and send monthly “Managed Care Denial Report” to appropriate department leaders including Physician Coding Manager, Physician Billing Manager, Director and VP of EEH Physician Practices, and Vice President of EEH Revenue Cycle. Maintain 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. (For AIP eligible positions) Premium pay such as shift, on call, holiday and more based on an employee’s job (For eligible positions) 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 Dormont Manufacturing Company