What are the responsibilities and job description for the Denials Management Coordinator position at Pain Specialists of America LLC?
Job Description
Job Description
Description :
Pain Specialists of America ("PSA") is a Texas-based, multisite comprehensive pain management company that includes over 15 locations. We are seeking talented professionals who can support the business and help it achieve its strategic objectives.
The Denials Management Coordinator is responsible for overseeing the resolution of denied claims and ensuring timely reimbursement from insurance carriers. This role involves analyzing denial trends, collaborating with clinical and administrative staff, and implementing corrective measures to improve denial rates. The ideal candidate will have experience in pain management and ambulatory surgery center (ASC) billing, including a strong understanding of coding, payer guidelines, and appeals processes.
Key Responsibilities
Denial Analysis and Resolution :
Review and analyze insurance denials, underpayments, and appeals for pain management services and ASC claims.
Investigate root causes of denials and develop strategies to address them.
Appeals and Follow-Up :
Prepare and submit detailed and timely appeals to insurance payers for denied or underpaid claims.
Maintain follow-up on outstanding appeals and claims to ensure resolution.
Trend Identification and Reporting :
Track and monitor denial trends to identify areas for improvement.
Provide regular reports to leadership on denial patterns, resolution rates, and financial impact.
Collaboration and Training :
Work closely with billing, coding, and clinical teams to address documentation and coding issues that lead to denials.
Compliance and Guidelines :
Stay current with industry standards, payer policies, and regulatory changes impacting billing and claims processing.
Ensure all activities comply with HIPAA and other relevant regulations.
System Optimization :
Utilize billing software and electronic medical records (EMR) systems to streamline denial management processes.
Recommend system and workflow improvements to enhance claim accuracy and efficiency.
Benefits
Medical, Dental, Vision Insurance
401k w / company match contribution
Paid Time Off
Short & Long-Term Disability
HSA (w / company match contribution), FSA
Life Insurance (company paid voluntary options)
10 Paid Holidays for the Year 2025
Employee Assistance Programs
Requirements :
Minimum of 3 years of experience in medical / facility denials management, or revenue cycle operations.
Experience in pain management and ASC experience required.
Proficiency in medical coding (CPT, ICD-10, and HCPCS) and knowledge of modifiers specific to pain management and surgical procedures.
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