Patient Accounting Denials Specialist

Presbyterian Healthcare Services; Albuquerque (NM); On-site; USD 23,000 - 37,000; Full time

Benefits offered by this job

Wellness program

Medical benefits

Smoke-free campuses

Job summary

Presbyterian Healthcare Services in Albuquerque seeks a Patient Accounting Denials Specialist I to perform denial analysis, follow-up, and appeals. Responsibilities include processing of requests, submitting corrected claims, and documenting activities in line with policy.

The role requires a high school diploma or GED with insurance-related training and at least two years of billing experience. Strong communication and teamwork are essential in a busy environment.

Qualifications

• High school degree or GED required with short-term training in insurance collections and claims processing.
• Minimum two years of experience in insurance follow-up, billing, and collections.
• Strong written and verbal communication skills; ability to work in a team and manage high-volume workload.

Responsibilities

• Perform root cause analysis and denial follow-up for assigned payors.
• Submit corrected claims, reconsiderations and appeals to overturn denials.
• Provide information requested by insurance companies and document accounts per policy.
• Utilize EHR, claims clearinghouse and payer portals to process denials and reconciliations.

Skills

Communication

Telephone Skills

Written Communication

Teamwork

Education

High school diploma or GED

Insurance collections training

Tools

Electronic Health Record

Claims clearinghouse

FISS/DDE

Payer portals

Microsoft Office

Job description

Location Address:9521 San Mateo NE Albuquerque, NM 87113-2237Compensation Pay Range:Minimum Offer $16.66 Maximum Offer $26.70 Now Hiring: Patient Accounting Denials SpecialistSummary:Build your Career. Make a Difference. Presbyterian is hiring a skilled Patient Accounting Denials Specialist I. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America)Responsibilities:Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A/R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activitiesPerforms denial follow-up activities for assigned payors utilizing work queues.Submits corrected claims, reconsiderations and/or appeals to overturn denials.Responsible for providing any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials.Must follow process/procedures to ensure timely follow up on outstanding denials.Document accounts in accordance with established PHS policies/procedures.Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.)Must utilize communication skills to be an effective team member.Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns.Must develop and maintain professional work relationships with team members, PHS departments and outside agencies.Qualifications:High school degree or GED required, short-term training on insurance collections and claims processing. Minimum two years experience in insurance follow-up, billing, and collections. Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.Must be passionate about being part of an organization focused on continuously improving patient experiences and the health of our community.Must have a strong work ethic and demonstrated ability to work effectively in a team environment.Must be able to prioritize and manage a high-volume workload and be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.WellnessPresbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.Why work at Presbyterian?As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.About Presbyterian Healthcare ServicesPresbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services