Denial Management Specialist - Physician Enterprise Revenue Cycle

Baxter Health; Mountain Home (AR); On-site; USD 42,000 - 58,000; Full time

Job summary

Baxter Health in Mountain Home, AR, is seeking a Denial Management Specialist for the Physician Enterprise Revenue Cycle to monitor denials, appeals, and resolutions with insurers, and to collaborate with practices to gather data.

You will analyze denial data to identify root causes, draft reconsideration letters, and serve as liaison between the PERC and physician practices to drive education and preventive actions.

Qualifications

• High school diploma or equivalent required.
• Minimum of two years’ experience with Medical Billing.
• Minimum of two years’ experience within the medical industry preferred.
• Experience working with both government and commercial payers required.

Responsibilities

• Monitor denials, appeals and resolutions from participating insurers.
• Create reconsideration letters and research denial data for root causes.
• Liaise between the PERC and Physician Practices to provide feedback and education.
• Proactively identify process improvements to prevent future denials.

Skills

Denial management

Medical billing

Payer relations

Root cause analysis

Education

High school diploma or equivalent

Associates degree (preferred)

Job description

Denial Management Specialist - Physician Enterprise Revenue Cycle

Baxter Health

Mountain Home , AR

Full time , Days

SUMMARY: The Denial Management Specialist is responsible for monitoring denials, appeals, and resolutions from participating insurance carriers and working proactively to collect under payments from insurance carriers. Maintains denial management processes, including but not limited to creation of reconsideration letters. Researches and analyzes denial data to include root cause of denial. This position will also serve as a liaison between the PERC and Physician Practices to provide feedback regarding findings and education to prevent future denials.

BAXTER HEALTH COMPLIANCE RESPONSIBILITIES

Understands and adheres to Baxter Health standards and policies.

Required to work with the Director regularly to carryout, initiate and/or implement best practices for the Baxter Health Physician Enterprise Revenue Cycle Department.

JOB REQUIREMENTS

Education: High school diploma or equivalent required

Experience: Minimum of two (2) years’ experience with Medical Billing required; Minimum of two (2) years’ experience within the medical industry is preferred; Experience working with both government and commercial payers required.

Preferred Education: Associates Degree

Safety Sensitive Designation:

No

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without an accommodation. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to perform the following: Must have the ability to communicate effectively, orally and in writing, to solve problems and make decisions. Spend eight hours or more in front of computer, monitor or similar screen utilizing keyboard and/or mouse, daily. Ability to stand and walk, bend, squat and twist, and occasionally lift up to 20 pounds with proper body mechanics. Must be able to handle critical and highly stressful situations with efficiency and composure.

Work Environment
Office setting, within an office environment