Denials Specialist

Tenet Healthcare Corporation; United States; Remote; USD 50,000 - 70,000; Full time

Job summary

A healthcare provider is looking for a Denials Specialist to validate denial reasons and generate appeals in a remote role. Qualified candidates should have 3-5 years of billing experience in a hospital environment and a high school diploma. Key responsibilities include researching contract terms and ensuring accurate coding in the DCM system.

Qualifications

• 3-5 years of experience in a hospital business environment.
• Intermediate understanding of Managed Care Contracts.
• Intermediate knowledge of UB-04 form requirements.

Responsibilities

• Validate denial reasons and ensure accurate coding in the DCM system.
• Generate appeals based on dispute reasons and payer contract terms.
• Research contract terms and compile documentation for appeals.

Skills

Billing and collections experience

Understanding of Explanation of Benefits (EOB)

Knowledge of ICD-9 coding

Education

High School Diploma or equivalent

Job description

A company is looking for a Denials Specialist - Remote.

Key Responsibilities

• Validate denial reasons and ensure accurate coding in the DCM system
• Generate appeals based on dispute reasons and payer contract terms
• Research contract terms and compile documentation for appeals

Required Qualifications

• High School Diploma or equivalent; some college coursework preferred
• 3-5 years of experience in a hospital business environment performing billing and/or collections
• Intermediate understanding of Explanation of Benefits (EOB) and Managed Care Contracts
• Intermediate knowledge of hospital billing form requirements (UB-04)
• Intermediate understanding of ICD-9, HCPCS/CPT coding, and medical terminology