DENIALS MANAGEMENT SPECIALIST

We seek a dedicated and detail-oriented Denials Management Specialist to join our team. In this role, you will manage and resolve denials, including charge entry, payment posting, follow-up, and collections. Your focus will be on maximizing client satisfaction while adhering to practice protocols.

Key Responsibilities:

• Manage and resolve denials and appeals, ensuring effective denial management and prompt reimbursement.
• Follow up on returned claims, correspondence, denials, account reconciliations, and rebills.
• Reduce accounts receivable of insurance balances by addressing outstanding accounts.
• Interpret and apply insurance payer guidelines, claim submission rules, and contract terms.
• Analyze accounts for proper claims processing and payment posting.
• Provide cross-coverage for team members and maintain regular communication with management about denial findings.
• Keep organized references on coding, insurance carriers, managed care networks, and credentialing.
• Maintain confidentiality and adhere to HIPAA standards.
• Other duties as assigned.

Qualifications:

• An associate degree or higher is preferred, or equivalent to 3-5 years of experience in medical billing.
• 3-5 years experience in medical billing and A/R management.
• Proficient in EPIC and Excel.
• Understanding of CPT/ICD10 coding and insurance carrier requirements.
• Excellent communication skills with internal and external customers.
• Ability to manage stressful situations calmly and effectively.

AS A CORELIFE TEAMMATE, YOU CAN EXPECT:

• Values-based culture
• A competitive salary based on experience ($22 - $28 an hour)
• Medical, dental, and vision insurance
• Wide selection of ancillary benefits
• Paid time off
• 7 paid holidays
• Retirement plan

CoreLife is an Equal Opportunity Employer.APPLY NOW