Denials & Appeals Specialist — Healthcare Revenue Cycle

Southwoods Health; Boardman (OH); Presencial; USD 42.000 - 64.000; Jornada completa

Descripción de la vacante

Southwoods Health is seeking a Denials Management Specialist to oversee procedural denial resolution and proactive follow-up with insurance carriers. You will manage worklists, communicate with payers, file appeals, and document all interactions to expedite payments while maintaining compliance.

This full-time role requires training in medical terminology and billing practices, with certification preferred, and emphasizes accuracy, ethics, and professional communication in a fast-paced revenue

Formación

• Education/training in business office operations, computer applications, and medical terminology.
• Certification in collections or billing is highly preferred.
• Strong knowledge of revenue cycle operations and denial resolution.
• Excellent communication and problem-solving skills.

Responsabilidades

• Worklist Management: Review tasks, credit balances, and denial worklists daily and weekly.
• Payer Correspondence: Contact insurance companies to determine status of unpaid or denied accounts.
• Documentation & Appeals: Prepare, file, and submit formal insurance appeals with required documentation.
• Account Logging: Detailed notes of all contact interactions in patient accounts.
• Claims & Resolutions: Mail claim forms with attachments, investigate credits, report billing errors.
• Industry Compliance: Monitor policy updates and ensure processes comply with agencies (OSHA, ODH, BOP, TJC).

Conocimientos

Communication

Problem solving

Professionalism

Ethical conduct

Educación

Business office training

Descripción del empleo

Southwoods Health is seeking a Denials Management Specialist to oversee procedural denial resolution and proactive follow-up with insurance carriers. You will manage worklists, communicate with payers, file appeals, and document all interactions to expedite payments while maintaining compliance.

This full-time role requires training in medical terminology and billing practices, with certification preferred, and emphasizes accuracy, ethics, and professional communication in a fast-paced revenue