Denials Management Specialist

Denials Management Specialist The Denials Management Specialist is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The specialist will work independently while managing their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered. Essential Functions and Responsibilities as Assigned: Monitors denial work queues and reports in accordance with assignments from direct supervisor. Maintains required levels of productivity while managing tasks in work queues to ensure timeliness of follow-up and appeals. Tracks and investigates denial trends/ root cause. Assists with claim audits as necessary. Makes management aware of any issues or changes in the billing system, insurance carriers, and/or network. Obtain retro authorizations and submit to payers for reimbursement. Ability to write non-clinical appeals with demonstrating proficiency with timely and successful submissions. As needed, participates in A/R clean-up projects or other projects identified by direct supervisor or CBS management. Works independently with other departments to resolve A/R and payer issues. Participates in departmental and team meetings involving discussion of A/R processes and trends. Knowledge of payer edits, rejections, rules, and how to appropriately respond to each to resolution. Qualifications: Required: High School Diploma or GED 7 years experience in Patient Accounting or Patient Access experience OR Associates Degree with 3 years of Patient Accounting or Patient Access experience McLaren Medical Group