Denials Management Specialist - remote

Baptist Health - Central Alabama; Pennsylvania; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player in healthcare services is seeking a dedicated billing and collections specialist. This role offers a unique opportunity to engage in meaningful work that directly impacts patient financial services while fostering a supportive and collaborative work environment. With a focus on career advancement, you will utilize your advanced knowledge of billing processes and regulations in a dynamic setting. If you are self-motivated and possess strong analytical and communication skills, this position could be the perfect fit for you. Join a team that values your contributions and supports your professional growth.

Benefits

Career Advancement Opportunities

Collaborative Work Environment

Continuing Education Participation

Qualifications

• 3+ years of experience in hospital billing or collections.
• Advanced knowledge of 1500/UB-04 forms and EOB interpretation.

Responsibilities

• Validate disputes and escalate payment variance trends to management.
• Generate appeals for denied claims and document collection activities.

Skills

Verbal Communication

Written Communication

Critical Thinking

Analytical Skills

Education

High School Diploma or Equivalent

Associate's Degree or Higher

Tools

Billing Software

Medical Coding Systems (CPT, ICD-10)

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:

1. Opportunity for career advancement and growth within the organization
2. Engaging in meaningful work that impacts patient financial services
3. Supportive and collaborative work environment
4. Chance to utilize advanced knowledge of billing and collections in a dynamic healthcare setting
5. Participation in continuing education related to payer and governmental policies

What to Expect (Job Responsibilities):

1. Validate dispute reasons and escalate payment variance trends or issues to management
2. Generate appeals for denied or underpaid claims and exhaust all appeal efforts based on payer guidelines
3. Research payer and governmental regulations, billing rules, and analyze managed care contracts
4. Provide feedback and recommendations regarding trends or issues to management teams
5. Accurately document all pertinent collection activity performed

What is Required (Qualifications):

1. High school graduate or equivalent
2. Minimum of at least 3 years of experience in a hospital business or medical office environment performing billing and/or collections
3. Advanced knowledge of 1500 and/or UB-04 and Explanation of Benefits (EOB) interpretation
4. Intermediate knowledge of CPT and ICD-10 codes
5. Excellent verbal and written communication skills

How to Stand Out (Preferred Qualifications):

1. Associates degree or higher
2. Advanced knowledge of insurance billing, collections, and insurance terminology
3. Advanced knowledge of reading and understanding managed care contracts and federal and state regulations
4. Strong critical thinking and analytical skills
5. Self-motivated with advanced business letter writing skills

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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.