Denials Management & Appeals Specialist

Endeavor Health; Arlington Heights (IL); On-site; USD 30,500 - 45,750; Full time

Benefits offered by this job

Shift pay

On-call pay

Holiday pay

Annual increases based on performance

Career growth opportunities

Medical, dental, vision options

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

Endeavor Health in Arlington Heights, IL seeks a Denial Management Specialist to review and resolve denied patient insurance claims, focusing on medical necessity, pre-certification, authorization, and level of care requirements. In this role you will collaborate with Physician Practices, Providers and Payers, submit timely appeals, gather medical records, and write appeal letters.

Strong computer skills and knowledge of CPT/ICD9 coding are required; high school diploma and 2 years of relevant

Qualifications

• High School diploma required.
• 2 years of patient billing or managed care experience preferred.
• Strong computer skills and knowledge of billing guidelines.

Responsibilities

• Review and resolve denied patient insurance claims.
• Collaborate with internal departments to determine denial appeal process and gather necessary information.
• Submit timely appeals by resubmitting corrected claims, medical records, and appeal letters.
• Provide process improvement recommendations to reduce future denials.
• Use software tools to identify denial trends and payer issues; share findings with stakeholders.
• Follow up on pending denials after appeals are processed with payers.

Skills

Computer skills

Billing guidelines

CPT/ICD9 coding

U&C schedules

Education

High School diploma

Job description

Endeavor Health in Arlington Heights, IL seeks a Denial Management Specialist to review and resolve denied patient insurance claims, focusing on medical necessity, pre-certification, authorization, and level of care requirements. In this role you will collaborate with Physician Practices, Providers and Payers, submit timely appeals, gather medical records, and write appeal letters.

Strong computer skills and knowledge of CPT/ICD9 coding are required; high school diploma and 2 years of relevant