Patient Financial Rep - Denials

CaroMont Health; Gastonia (NC); On-site; USD 38,000 - 52,000; Full time

Job summary

CaroMont Health is seeking a Patient Financial Representative (Denials) to ensure accurate, timely follow-up of denied government and commercial claims. You will work to secure prompt resolutions while adhering to payer rules and guidelines, engaging with payers, patients, and physicians as needed.

The role requires at least a high school diploma and 6 months of billing/collection experience, with strong communication and analytical skills, and knowledge of insurance principles.

Qualifications

• High School diploma or equivalent required, with at least 6 months billing/collection experience.
• Hospital experience preferred.
• Strong conversational and analytical skills.
• Knowledge of insurance principles and practices.
• Ability to interact with payers in an assertive yet tactful manner.
• Data entry ability.

Responsibilities

• Follow up on Medicare, Medicaid and other denied claims to secure timely resolution.
• Proactively pursue denied accounts using work queues by phone, fax, on-line systems, and written communications.
• Coordinate with patient, payer, and interdepartmental teams and physician offices as needed.

Skills

Billing & Collections

Communication

Analytical thinking

Insurance knowledge

Data entry

Education

High School diploma

Job description

Job Summary:

The objective of the Patient Financial Representative (Denials) is to ensure accurate and timely follow up of Medicare, Medicaid, other government, commercial, managed care, and worker’s compensation denied claims. The primary function of this role is to follow up on accounts that have denied in order to secure resolution in a prompt manner that follows all government and commercial/managed care payer rules and regulations. Representatives will use work queues to proactively follow up on denied accounts via telephones, fax and on-line systems and written communications. This may include but will not be limited to patient contact, payer contact, interdepartmental contact, and physician office communications.

Qualifications:

High School diploma or equivalent required with at least 6 months prior billing and/or collection experience; hospital experience preferred. Strong conversational and analytical skills required. Must have knowledge of insurance principles and practices. Ability to interact with payers in an assertive yet tactful manner. Data entry ability .