Denials Specialist — Entry-Level with Tuition Reimbursement

Ensemble Health Partners; Connecticut; Híbrido; USD 42 000 - 64 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Bonus incentives

Tuition Reimbursement

Comprehensive Benefits

Career advancement

Resumo da oferta

Ensemble Health Partners is hiring a Denials Specialist for our US operations. The role focuses on clinically related claim denials, contacting plans, analyzing reasons for denials, and determining if appeals are needed.

Responsibilities include preparing appeal materials, gathering medical records, and coordinating with providers to obtain necessary documentation for timely submissions. Entry level with opportunities for growth and advancement.

Qualificações

• 1–3 years of denials or accounts receivable experience.
• Associate’s degree or equivalent experience required.
• Knowledge of hospital operations, chart audit/review, and provider relations is preferred.

Responsabilidades

• Analyze claims, remittances, denial letters, and contact payers to determine root causes of denials and steps to resolution.
• Assess claims and determine if an appeal is necessary.
• Prepare appeal materials, including correcting and resubmitting claims and gathering medical records.
• Act as liaison between healthcare providers for documentation and clarification, and submit appeals timely.

Conhecimentos

Denials management

Revenue cycle knowledge

Medical records review

Communication skills

Formação académica

Associate’s degree or Equivalent Experience

Ferramentas

EMR/EHR systems

AI in processes

Descrição da oferta de emprego

Ensemble Health Partners is hiring a Denials Specialist for our US operations. The role focuses on clinically related claim denials, contacting plans, analyzing reasons for denials, and determining if appeals are needed.

Responsibilities include preparing appeal materials, gathering medical records, and coordinating with providers to obtain necessary documentation for timely submissions. Entry level with opportunities for growth and advancement.