Denial Management Specialist

Lyros Technologies Pvt Ltd-CMMI Level 3; Hyderabad; On-site; INR 600,000 - 900,000; Full time

Job summary

Lyros Technologies Pvt Ltd-CMMI Level 3 is seeking a Denial Management Specialist in Andhra Pradesh to manage and resolve claim denials, aiming to maximize revenue and strengthen payer relationships. The role requires analyzing denial trends, identifying root causes, and implementing effective solutions to reduce future denials.

Responsibilities include reviewing denied claims, coordinating documentation for appeals, submitting appeals to payers, tracking status, and maintaining records.

Qualifications

• Experience with denial management processes in healthcare billing.
• Strong analytical and problem-solving abilities.

Responsibilities

• Review denied claims to determine reasons for denial.
• Coordinate with internal teams to gather documentation for appeals.
• Prepare and submit payer appeals in a timely, compliant manner.
• Monitor status of appeals and perform follow-ups as needed.
• Identify denial trends and work with management on strategies.
• Maintain accurate records of denial management activities and outcomes.
• Provide training and support on best practices to prevent denials.

Skills

Denial management

Healthcare billing

Analytical skills

MS Office

Communication skills

Teamwork

Tools

Healthcare management software

Microsoft Office Suite

Job description

We are seeking a Denial Management Specialist to join our team in Andhra Pradesh. The ideal candidate will play a crucial role in managing and resolving claims denials, ensuring that our organization maximizes revenue and maintains strong relationships with payers. This position requires a detail-oriented individual who can analyze denial trends, identify root causes, and implement effective solutions to reduce future denials.

Key Responsibilities

• Review and analyze denied claims to determine the reasons for denial.
• Collaborate with internal teams to gather necessary documentation and information to support appeals.
• Prepare and submit appeals to payers in a timely manner, ensuring compliance with all regulations.
• Monitor and track the status of appeals and follow up as necessary.
• Identify trends in denials and work with management to develop strategies to address these issues.
• Maintain accurate records of all denial management activities and outcomes.
• Provide training and support to staff on best practices for preventing denials.

Required Skills

• Strong understanding of denial management processes and healthcare billing.
• Excellent analytical and problem-solving skills.
• Proficient in using healthcare management software and Microsoft Office Suite.
• Strong communication skills, both written and verbal.
• Ability to work independently and as part of a team.

If you are a motivated individual with a passion for improving healthcare revenue cycle processes, join us in making a difference in the healthcare industry by ensuring that our services are compensated fairly and efficiently.