Denials & Appeals Specialist, Patient Accounts

Torrance Memorial Medical Center; Torrance (CA); On-site; USD 35,000 - 53,000; Full time

Job summary

Torrance Memorial Medical Center is seeking a Denials Patient Account Representative to review denied claims, manage the appeals process, and maintain relationships with third-party payers. The role supports the Revenue Cycle by reporting and assisting with process improvements to maximize case flow and reduce denials.

The ideal candidate has a Bachelor's or Associate degree with healthcare financial services experience and at least two years in healthcare billing or denials management, with

Qualifications

• Bachelor's degree in business, healthcare, or related field or Associate's degree with 3 years of patient financial services.
• 2 years of experience in Healthcare billing, collections, payment processing or denials management.
• Knowledge of state/federal laws related to contracts and to the appeals process.

Responsibilities

• Execute the denial appeals process with third-party payers in a timely manner.
• Track the status and progress of denials and appeals.
• Conduct research to assist with completing appeals and stay informed on best practices.
• Maintains data on denied claims and root causes; collaborates on improvements.
• Prepare, maintain, and submit reports as required.
• Collaborate with internal departments and external organizations to resolve appeals.
• Prioritize workload to meet deadlines.
• Promote positive customer relations.

Skills

Denials appeals

Payer communications

Data analysis

Process improvement

Customer relations

Prioritization

Education

Bachelor's or Associate degree in related field

Job description

Torrance Memorial Medical Center is seeking a Denials Patient Account Representative to review denied claims, manage the appeals process, and maintain relationships with third-party payers. The role supports the Revenue Cycle by reporting and assisting with process improvements to maximize case flow and reduce denials.

The ideal candidate has a Bachelor's or Associate degree with healthcare financial services experience and at least two years in healthcare billing or denials management, with