Job Summary
The Denials Management Specialist is responsible for working assigned denials and appeals claims by communicating with all necessary departments to identify and resolve denials trends and issues.
Essential Functions
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Monitoring correspondence and assigning it to pools within Artiva, HMS, Hyland, BARRT and other host systems and applications with currency to follow up dates.
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Communicates with all necessary departments to identify and resolves denial trends and issues. Tracks and documents all denial and appeal activity.
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Maintains working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
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Payor portal knowledge.
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Maintains BARRT requests (Outbound/Inbound) timely. Maintain all logs, account notes and system records as assigned.
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Performs other duties as assigned.
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Complies with all policies and standards.
Qualifications
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H.S. Diploma or GED required
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1-3 years experience in healthcare setting with experience in medical terminology required
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1-3 years Experience in revenue cycle processes in a hospital or physician office required
Knowledge, Skills and Abilities
- Intermediate knowledge of Microsoft Office tools or Google platforms
Equal Employment Opportunity
This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.
