Denials & Appeals Specialist

1201 Northwest Community Hospital; Arlington Heights (IL); On-site; USD 31,000 - 46,000; Full time

Benefits offered by this job

Shift pay

On-call pay

Holiday pay

Tuition Reimbursement

Free Parking

Wellness Program

Job summary

Endeavor Health Careers is seeking a Denial Management Specialist in Arlington Heights, IL. You will review denied patient insurance claims, coordinate with internal departments, and contact payers or patients to gather information for appeals.

The role requires a High School education and at least 2 years in patient billing or managed care, with strong computer skills and knowledge of CPT/ICD9 coding. We offer comprehensive benefits and growth opportunities.

Qualifications

• Education: High School
• Experience: 2 years in patient billing or 2 years managed care
• Skills: Extensive computer knowledge; CPT/ICD9 coding; knowledge of standard billing guidelines; U&C schedules

Responsibilities

• Reviews and resolves denied patient insurance claims.
• Works closely with internal departments in determining accurate denial and process for appeal.
• Contacts insurance companies/payer or patients to gather information necessary to complete the appeal process.
• Sends appeals to insurance companies regarding denials by resubmitting corrected claim, submitting medical records and writing appeals letters in a timely manner.
• Provides process improvement recommendations to Supervisor to decrease future denials.
• Utilizes software tools to identify denial, trends and payer issues.
• Shares findings with stakeholders.
• Follows up on pending claim denials after appeal has been processed -by the insurance company.
• Collaborates in the collection of data and sends monthly “Managed Care Denial Report” to appropriate department Leaders including: Physician Coding Manager; Physician Billing Manager and Director, VP of EEH Physician Practices and Vice President of EEH Revenue Cycle.
• Maintains positive working relationships both externally and internally.

Skills

Extensive computer knowledge

CPT/ICD9 coding

U & C schedules

Education

High School

Job description

Endeavor Health Careers is seeking a Denial Management Specialist in Arlington Heights, IL. You will review denied patient insurance claims, coordinate with internal departments, and contact payers or patients to gather information for appeals.

The role requires a High School education and at least 2 years in patient billing or managed care, with strong computer skills and knowledge of CPT/ICD9 coding. We offer comprehensive benefits and growth opportunities.