AR Denials Lead: Payment Resolution & Coaching

Healthrise; Farmington Hills (MI); In loco; USD 60.000 - 80.000; Tempo pieno

Descrizione del lavoro

Healthrise is seeking a Denials Resolution Specialist to perform day-to-day payment resolution activities within the hospital revenue operations setting. You will handle post-billed denials, including clinical denials, and act as first-line support, coach, and quality reviewer for AR Specialists.

The role requires experience with Medicare and California payors, strong communication, and attention to detail to minimize delays and maximize reimbursement.

Competenze

• Excellent written and verbal communication and organizational skills.
• Hands-on experience with revenue cycle processes and denials resolution.
• Detail-oriented with strong time management and multitasking abilities.

Mansioni

• Receives, analyzes, and appeals denials; researches and resolves payment delays and variances.
• Works hospital HB Medicare denials and underpayments, applying Medicare rules, edits, and appeals.
• Handles California payors, including Medi-Cal and other plans, with payor-specific rules.
• Processes payments per contracts and policies to ensure timely resolution.
• Investigates overpayments/underpayments to optimize reimbursement.
• Documents actions in the patient accounting system and communicates with payers and patients.

Conoscenze

Communication

Interpersonal skills

Attention to detail

Time management

Customer service

Formazione

High school diploma or Associate degree in Accounting/Business Administration

Strumenti

Epic

Descrizione del lavoro

Healthrise is seeking a Denials Resolution Specialist to perform day-to-day payment resolution activities within the hospital revenue operations setting. You will handle post-billed denials, including clinical denials, and act as first-line support, coach, and quality reviewer for AR Specialists.

The role requires experience with Medicare and California payors, strong communication, and attention to detail to minimize delays and maximize reimbursement.