Medical Claims Recovery & Denial Specialist

100 LCMC Health; New Orleans (LA); Sur place; USD 42 000 - 64 000; Plein temps

Résumé du poste

LCMC Health in New Orleans seeks a detail-oriented professional to manage collections and denial management. You will ensure timely action on assigned accounts, analyze underpayments, and process denials and appeals with payers.

Responsibilities include reviewing payments, analyzing EOBs, documenting activities on patient accounts, and collaborating with internal teams to secure proper reimbursement while maintaining HIPAA compliance.

Qualifications

• Minimum two years of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management is preferred
• A high school diploma or GED is required
• Must be able to pass a basic computer skills test and system level training
• Knowledge of hospital and professional billing processes and reimbursement
• Understanding of third-party contracting and insurance protocols
• ERISA guidelines for denials and appeals; regulations related to denials and appeals
• Ability to identify problems, propose resolutions, and implement changes
• Strong time-management and multitasking abilities; excellent customer service
• Excellent written and communication skills; comfortable with computer systems

Responsabilités

• Manage collections and denial management to ensure timely action on assigned accounts
• Identify and analyze underpayments; process denials and appeals as needed
• Review posted payments and adjustments for accuracy
• Analyze EOBs to ensure proper reimbursement
• Research to complete appeals with third-party payers, ensuring documentation and timely responses
• Communicate with payers on outstanding claims to resolve variances and expedite reimbursement
• Accurately document all activity on patient accounts
• Collaborate with internal departments and external organizations to ensure correct reimbursement and resolve appeals
• Monitor trends in underpaid/denied claims and report findings to management
• Adhere to HIPAA and facility guidelines; participate in staff training on improvement opportunities

Description du poste

LCMC Health in New Orleans seeks a detail-oriented professional to manage collections and denial management. You will ensure timely action on assigned accounts, analyze underpayments, and process denials and appeals with payers.

Responsibilities include reviewing payments, analyzing EOBs, documenting activities on patient accounts, and collaborating with internal teams to secure proper reimbursement while maintaining HIPAA compliance.