Claims Denials & Eligibility Specialist

North American Partners in Anesthesia; Florida; Remote; USD 26,000 - 30,000; Full time

Benefits offered by this job

Paid Time Off

Health, life, vision, dental, and AD&D

FSA/HSA

401(k)

Job summary

North American Partners in Anesthesia in Sunrise, FL is seeking a Rejections and Denials Specialist to manage denied eligibility claims across multiple payers and states, working in several queues and contacting payers by phone or online.

The role requires 3+ years of eligibility/denials experience, Medicare/Medicaid knowledge, strong MS Word/Excel skills, and excellent communication with payers and patients. A high school diploma is required, with emphasis on HIPAA and confidentiality.

Qualifications

• High school diploma or equivalent certification required.
• 3+ years of eligibility-related knowledge and denials management experience.
• Experience with Medicare/Medicaid, HMOs, and PPOs.
• Strong computer skills including MS Word and Excel.
• Excellent communication with patients, payers, and co-workers.
• Ability to work independently and in a team.
• HIPAA compliance and confidentiality.
• Ability to multitask and manage time effectively.

Responsibilities

• Analyze patient insurance to identify the correct plan selected.
• Document steps to ensure accounts are worked correctly.
• Troubleshoot and resolve issues; contact payers or patients as needed.
• Identify billing errors and correction errors through research.
• Follow department procedures and policies.
• Evaluate insurance payor setup with the billing system.
• Assist management in optimizing the efficiency of the eligibility team.
• Assist with training staff and colleagues.

Skills

Customer service

Critical thinking

Communication

Multitasking

Team collaboration

Attention to detail

HIPAA compliance

Education

High school diploma or equivalent

Tools

MS Word

Excel

Job description

North American Partners in Anesthesia in Sunrise, FL is seeking a Rejections and Denials Specialist to manage denied eligibility claims across multiple payers and states, working in several queues and contacting payers by phone or online.

The role requires 3+ years of eligibility/denials experience, Medicare/Medicaid knowledge, strong MS Word/Excel skills, and excellent communication with payers and patients. A high school diploma is required, with emphasis on HIPAA and confidentiality.