Denials Specialist

Midwest Vision Partners, LLC; United States; On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Competitive wages

Medical, dental, life and disability (

Insurance

Job summary

Midwest Vision Partners is seeking a Denials Specialist to manage accounts receivable follow-up and denial resolution. You will work with payers, examine EOBs, and use payer portals to maintain accurate patient accounts, ensuring timely cash collections and compliance.

The role emphasizes thorough documentation, adherence to HIPAA, and collaboration with management to identify payer trends and process improvements. A healthcare AR background is preferred.

Qualifications

• High school diploma or equivalent.
• Previous healthcare AR experience.
• Ability to read various EOBs.
• Knowledge of payer portals.
• Medicare and Medicaid knowledge.
• Excellent written and verbal communication skills.
• Excellent computer skills, including Excel, Word, and RCM systems as needed.
• Highly organized, detail-oriented, strong work ethic, and demonstrated teamwork skills.
• Ability to multitask and meet deadlines.

Responsibilities

• Accounts Receivable follow-up, including collections and denials resolution.
• Direct calling to payers and use of payer portals.
• Working in patient account systems, work queues, and Excel documents.
• Credit balance resolution and reconciling patient accounts.
• Placing outbound calls to insurance companies to resolve claims and balances.
• Demonstrating knowledge of Medicare, Medicaid, government, and commercial payers.
• Performing month-end close procedures within established time frames.
• Communicating payer and account issues to management in a timely manner.
• Maintaining HIPAA and privacy/compliance standards.

Skills

Accounts Receivable Management

EOB reading

Payer portals

Medicare/Medicaid knowledge

Excel skills

Education

High school diploma

Tools

Excel

Word

RCM systems

Job description

Denials Specialist

The Denials Specialist role is responsible for the follow up and collections of accounts on the accounts receivable. This includes general payer collections and denial follow-up. In addition, this role could oversee the intake of patient calls. This position performs various accounting, customer service and organizational tasks to promote the financial health of the organization.

The identification of Duties and Responsibilities does not display an exhaustive list of all duties that may be assigned to this position, nor does it restrict the related work that may be assigned to this position.

What you will be doing

• Accounts Receivable follow-up, including collections and denials resolution

  • Direct calling to payers and use of payer portals

  • Working in patient account systems, work queues, and Excel documents

• Credit balance resolution

  • Interpreting various Explanation of Benefits (EOBs) to reconcile patient accounts, determine appropriate balances, and identify necessary actions, including refunds or takebacks

• Placing outgoing calls to insurance companies to resolve outstanding claims and balances

• Demonstrating working knowledge of Medicare, Medicaid, government, and commercial payers

• Identifying trends and communicating payer scenarios

• Performing month-end close procedures within established time frames

• Communicating payer and account issues to management in a timely manner

• Monitoring accounts for other opportunities, including copays, deductibles, and coinsurance

• Entering clear and concise comments in the software system for tracking and documentation

• Ensuring adherence to HIPAA standards and all other privacy and compliance policies

• Staying knowledgeable on payer and contract updates and bulletins

• Performing other duties as assigned to support the financial health of the organization

What you know

Required

• High school diploma or equivalent

• Previous healthcare experience in Accounts Receivable Management

• Ability to read various EOBs

• Knowledge of payer portals

• Medicare and Medicaid knowledge

Desired

• Excellent written and verbal communication skills

• Excellent computer skills, including Excel, Word, and RCM systems as needed

• Highly organized, detail-oriented, strong work ethic, and demonstrated teamwork skills

• Ability to multitask and meet deadlines

What you will receive

• Competitive wages

• Robust benefit package including medical, dental, life and disability (short- and long-term) insurance

• Generous paid time off (PTO) program

• Seven (7) company paid holidays

• 401(k) retirement plan with company match

• An organization focused on People, Passion, Purpose and Progress

• Inspirational culture

About Midwest Vision Partners

Vision is a precious gift. Midwest Vision Partners (MVP) is focused on improving and preserving it for as many patients as possible by cultivating a network of world-class ophthalmologists and optometrists who provide exceptional, patient-centered care. Midwest Vision Partners was founded in 2019 in partnership with Alpine Investors. Headquartered in Chicago, MVP proudly supports prominent eye care professionals in 70+ locations across Ohio, Michigan, Pennsylvania, West Virginia, and Illinois, with over 140 physicians and 1500 employees all focused on providing top-notch, customized results for each of our patients.