Denial Management Specialist

Denial Management Specialist

Trinity Employment Specialists-Tulsa, OK

Monday-Friday | $21-$22/hour | Temp to hire

Summary: Under the direct supervision of the Billing Manager, the Appeal and Complex denial Management Specialist is responsible for:

• -Systematically investigating each denial and compile appeal for corrected claims which have previously been denied by payers.
• -Proactively monitoring and keeping up with AR for the assigned payers 
• -Uncovering trends by one or more insurance carriers and recommend the process to prevent or reduce the risk of future claims denials.

Requirements:

• -Excellent at navigating through the payer portals and should have good understanding of insurance reimbursement guidelines.
• -Proficient at filing appeals for the denials if needed
• 3-5 years denial and appeals working experience in physician billing

Education:

 -High School Required, associate degree preferred

-Coding education required, Coding certification would be a PLUS.

#BA

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* Compile, compute, and record billing, accounting, statistical, and other numerical data for billing purposes. Prepare billing invoices for services rendered or for delivery or shipment of goods.
* Verify accuracy of billing data and revise any errors.
* Resolve discrepancies in accounting records.
* Prepare itemized statements, bills, or invoices and record amounts due for items purchased or services rendered.
* Operate typing, adding, calculating, or billing machines.
* Post stop-payment notices to prevent payment of protested checks.
* Verify signatures and required information on checks.
* Keep records of invoices and support documents.
* Perform bookkeeping work, including posting data or keeping other records concerning costs of goods or services or the shipment of goods.
* Contact customers to obtain or relay account information.
* Route statements for mailing or over-the-counter delivery to customers.
* Monitor equipment to ensure proper operation.
* Fix minor problems, such as equipment jams, and notify repair personnel of major equipment problems.
* Review documents, such as purchase orders, sales tickets, charge slips, or hospital records, to compute fees or charges due.
* Track accumulated hours and dollar amounts charged to each client job to calculate client fees for professional services, such as legal or accounting services.
* Weigh envelopes containing statements to determine correct postage and affix postage, using stamps or metering equipment.
* Consult sources, such as rate books, manuals, or insurance company representatives, to determine specific charges or information such as rules, regulations, or government tax and tariff information.
* Compare previously prepared bank statements with canceled checks and reconcile discrepancies.
* Match statements with batches of canceled checks by account numbers.
* Take orders for imprinted checks.
* Encode and cancel checks, using bank machines.
* Load machines with statements, cancelled checks, or envelopes to prepare statements for distribution to customers or stuff envelopes by hand.
* Compute credit terms, discounts, shipment charges, or rates for goods or services to complete billing documents.
* Update manuals when rates, rules, or regulations are amended.
* Estimate market value of products or services.
* Review compiled data on operating costs and revenues to set rates.
* Answer inquiries regarding rates, routing, or procedures.
* Compile reports of cost factors, such as labor, production, storage, and equipment.
* Create billing documents, shipping labels, credit memorandums, or credit forms.
* Perform general administrative tasks, such as answering telephones, scheduling appointments, and ordering supplies or equipment.
* Return checks to customers or retrieve checks returned to customers in error, adjusting accounts and answering inquiries about errors as necessary.

Salary : $21 - $22