Denials Management & Appeals Specialist

Southwoods Health; Boardman (OR); Vor Ort; USD 45.000 - 65.000; Vollzeit

Zusammenfassung

Southwoods Health in Oregon is seeking a Denials Management Specialist to actively pursue payments from insurers by following up on aged, unpaid claims and handling strategic appeals. The role emphasizes proactive communication with carriers and timely resolution to improve cash flow.

You will manage denial worklists, document all interactions, prepare supporting documentation, and collaborate with the billing team to identify and correct billing errors, while staying compliant with OSHA, ODH,

Qualifikationen

• Completed training or courses in business office operations, computer applications, and medical terminology.
• Collection or billing certification is highly preferred.
• Comprehensive knowledge of the revenue cycle and resolving complex claim issues.

Aufgaben

• Review denial worklists and manage tasks on a daily/weekly basis.
• Contact insurance carriers to determine unpaid/denied account status and navigate payer portals.
• Prepare and submit formal insurance appeals with required documentation.
• Log all communications and maintain detailed notes in patient accounts.
• Investigate billing errors, report to supervisor, and assist with policy corrections.
• Stay updated on insurance policy changes to ensure regulatory compliance.

Kenntnisse

Effective communication

Problem solving

Ethical conduct

Ausbildung

Training in business office operations, computer applications, and medical terminology

Jobbeschreibung

Southwoods Health in Oregon is seeking a Denials Management Specialist to actively pursue payments from insurers by following up on aged, unpaid claims and handling strategic appeals. The role emphasizes proactive communication with carriers and timely resolution to improve cash flow.

You will manage denial worklists, document all interactions, prepare supporting documentation, and collaborate with the billing team to identify and correct billing errors, while staying compliant with OSHA, ODH,