Denial Management Specialist

milebluff; Mauston (WI); On-site; USD 55,000 - 75,000; Full time

Job summary

milebluff in Wisconsin is seeking a Denial Management Specialist to strengthen revenue cycle controls and reduce denials. The role analyzes data, creates reports, and collaborates with departments to educate on denial trends and pursue process improvements.

Qualifications include a high school diploma, AA or 4 years of equivalent experience, and 5+ years in related work; healthcare experience preferred. Exceptional accuracy and attention to detail are required.

Qualifications

• High school diploma or equivalent required.
• AA or 4 years of equivalent experience required.
• 5+ years of related work experience preferred.
• Experience working in the medical industry preferred.
• Exceptional accuracy and attention to detail required.

Responsibilities

• Creates Revenue Cycle reports.
• Responsible for collecting, researching and analyzing business and operational data.
• Provides monitoring and trending of system denials.
• Works with other departments, including operational, to reduce the dollar amounts of denials and rework.
• Works denials to resolution.
• Collaborates with other revenue cycle departments to educate on denial trends.
• Identifies and monitors process improvement efforts with the revenue cycle.
• Establishes definitions and criteria for reporting avoidable denials.
• Attends workshops and seminars to maintain a high level of knowledge and capabilities related to position.
• Perform other duties as requested.

Education

AA or 4 years of equivalent experience

Job description

General Information:

Job title: Denial Management Specialist

Schedule: Full-time, 80 hours per pay period; Monday-Friday, 8:00am - 4:30pm

Weekend rotation: No weekends

Holiday rotation: Paid Holidays

Position Summary:

The Denial Management Specialist position gathers, interprets, and reviews data to assess for root cause analytics to then implement process improvement to reduce denials and write offs to optimize A/R.

Position Responsibilities:

• Creates Revenue Cycle reports
• Responsible for collecting, researching and analyzing business and operational data.
• Provides monitoring and trending of system denials.
• Works with other departments, including operational, to reduce the dollar amounts of denials and rework.
• Works denials to resolution.
• Collaborates with other revenue cycle departments to educate on denial trends.
• Identifies and monitors process improvement efforts with the revenue cycle.
• Establishes definitions and criteria for reporting avoidable denials.
• Attends workshops and seminars to maintain a high level of knowledge and capabilities related to position.
• Perform other duties as requested.

Position Requirements:

• High school diploma or equivalent required.
• AA or 4 years of equivalent experience required.
• 5+ years of related work experience preferred.
• Experience working in the medical industry preferred.
• Exceptional accuracy and attention to detail required.

Knowledge, Skills, & Abilities

• Intermediate to Expert proficiency with computers is required.
• Thorough understanding of billing process.
• Basic understanding of coding.
• Strong quantitative and analytical competency.
• Self-starter with excellent interpersonal communication and problem-solving skills.