Denials & Appeals Specialist

Edward Elmhurst Health; Arlington Heights (IL); On-site; USD 27,552 - 45,460; Full time

Benefits offered by this job

Premium pay: shift/on-call/holiday

Tuition Reimbursement

Free Parking

Wellness Program Savings Plan

Health Savings Account Options

Retirement Options with Company Match

Paid Time Off and Holidays

Community Involvement Opportunities

Job summary

Edward-Elmhurst Health in Arlington Heights, IL seeks a Denial Management Specialist to review and resolve denied patient insurance claims within standard business hours. The role collaborates across departments to determine denial causes and streamline the appeal process, communicating with payers and patients as needed.

Responsibilities include preparing appeals with necessary medical records and supporting documents, following up after appeals, and contributing to process improvements to

Qualifications

• Extensive computer knowledge and experience.
• Knowledge of standard billing guidelines, CPT/ICD9 coding, usual and customary (U&C) schedules.

Responsibilities

• Review and resolve denied patient insurance claims.
• Collaborate with internal departments to determine the denial and appeal process.
• Contact insurance companies or patients to gather information for the appeal.
• Submit appeals with corrected claims, medical records, and appeal letters.

Skills

Computer skills

Billing guidelines

CPT/ICD9 coding

U&C schedules

Education

High School Diploma

Job description

Edward-Elmhurst Health in Arlington Heights, IL seeks a Denial Management Specialist to review and resolve denied patient insurance claims within standard business hours. The role collaborates across departments to determine denial causes and streamline the appeal process, communicating with payers and patients as needed.

Responsibilities include preparing appeals with necessary medical records and supporting documents, following up after appeals, and contributing to process improvements to