Patient Accounting Denials Specialist

				Overview:

Now hiring a Patient Accounting Denials Specialist

Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A/R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activities.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

* Full Time - Exempt: No
* Job is based Rev Hugh Cooper Admin Center
* Work hours: Days
* Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Ideal Candidate: High school degree or GED, Two years experience in insurance follow-up, billing, and collections

Responsibilities:

* Performs denial follow-up activities for assigned payors utilizing work queues.
* Submits corrected claims, reconsiderations and/or appeals to overturn denials.
* Responsible for providing any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials.
* Must follow process/procedures to ensure timely follow up on outstanding denials.
* Document accounts in accordance with established PHS policies/procedures.
* Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.)
* Must utilize communication skills to be an effective team member.
* Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns.
* Must develop and maintain professional work relationships with team members, PHS departments and outside agencies.
* Maintains strictest confidentiality, adheres to all HIPAA and CMS compliance rules and regulations.
* Perform other duties as assigned by the Denial Supervisor and/or Manager.

Qualifications:

* High school degree or GED required, short-term training on insurance collections and claims processing.
* Minimum two years experience in insurance follow-up, billing, and collections.
* Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.
* Must be passionate about being part of an organization focused on continuously improving patient experiences and the health of our community.
* Experience with Microsoft Office Suite products preferred. Excellent organizational, problem-solving, verbal, and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams are required.
* Must have a strong work ethic and demonstrated ability to work effectively in a team environment.
* Must be able to prioritize and manage a high-volume workload and be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.
			

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Presbyterian Healthcare Services