Medical Denials & Appeals Specialist

LCMC Health; New Orleans (LA); Sur place; USD 42 000 - 62 000; Plein temps

Résumé du poste

LCMC Health in New Orleans, LA is seeking a Collector responsible for collections and denial management to ensure timely action on assigned accounts. You will review EOBs, analyze underpayments, file appeals when needed, and communicate with third-party payers to resolve outstanding claims while maintaining HIPAA compliance.

This role emphasizes accuracy, timely follow-up, and collaboration with internal teams to optimize reimbursement processes.

Qualifications

• Minimum two years in a healthcare environment, particularly in billing, collections, or denial management.
• Strong understanding of hospital and professional billing processes and reimbursement.
• Knowledge of ERISA guidelines for denials and appeals.

Responsabilités

• Manage collections and denial management ensuring timely action on accounts.
• Identify and analyze underpayments and process denials and appeals as needed.
• Review posted payments and adjustments for accuracy.
• Analyze EOBs to ensure proper reimbursement and conduct relevant appeals research.
• Communicate with payers on outstanding claims and resolve variances.
• Document all activity on patient accounts and collaborate with internal/external teams.
• Monitor trends in underpaid/denied claims and report findings to supervision.
• Adhere to HIPAA and organizational guidelines; participate in staff training.

Connaissances

Collections

Denial Management

Payer communications

HIPAA compliance

Customer service

Time management

Multitasking

Data entry

Formation

High school diploma or GED

Description du poste

LCMC Health in New Orleans, LA is seeking a Collector responsible for collections and denial management to ensure timely action on assigned accounts. You will review EOBs, analyze underpayments, file appeals when needed, and communicate with third-party payers to resolve outstanding claims while maintaining HIPAA compliance.

This role emphasizes accuracy, timely follow-up, and collaboration with internal teams to optimize reimbursement processes.