Rejection and Denial Specialist (Remote)

North American Partners in Anesthesia; Florida; Remote; USD 26,000 - 30,000; Full time

Benefits offered by this job

Paid Time Off

Health, life, vision, dental, and AD&D

FSA/HSA

401(k)

Job summary

North American Partners in Anesthesia in Sunrise, FL is seeking a Rejections and Denials Specialist to manage denied eligibility claims across multiple payers and states, working in several queues and contacting payers by phone or online.

The role requires 3+ years of eligibility/denials experience, Medicare/Medicaid knowledge, strong MS Word/Excel skills, and excellent communication with payers and patients. A high school diploma is required, with emphasis on HIPAA and confidentiality.

Qualifications

• High school diploma or equivalent certification required.
• 3+ years of eligibility-related knowledge and denials management experience.
• Experience with Medicare/Medicaid, HMOs, and PPOs.
• Strong computer skills including MS Word and Excel.
• Excellent communication with patients, payers, and co-workers.
• Ability to work independently and in a team.
• HIPAA compliance and confidentiality.
• Ability to multitask and manage time effectively.

Responsibilities

• Analyze patient insurance to identify the correct plan selected.
• Document steps to ensure accounts are worked correctly.
• Troubleshoot and resolve issues; contact payers or patients as needed.
• Identify billing errors and correction errors through research.
• Follow department procedures and policies.
• Evaluate insurance payor setup with the billing system.
• Assist management in optimizing the efficiency of the eligibility team.
• Assist with training staff and colleagues.

Skills

Customer service

Critical thinking

Communication

Multitasking

Team collaboration

Attention to detail

HIPAA compliance

Education

High school diploma or equivalent

Tools

MS Word

Excel

Job description

Sunrise,FL - USAPosition RequirementsThe Rejections and Denials Specialist will be responsible to work the denied eligibility claims for all assigned payers and states. This will include working within multiple work queues, contact payers online or by phone, updating accounts as needed, and identifying carrier-related denial trends. This position will need to maintain a thorough knowledge and understanding of all charge corrections and FSC transfers, on top of understanding the differences. Familiarity with anesthesia modifiers, procedure codes and diagnostic codes. In addition, there may be projects that may require a manual process by reviewing and working off spreadsheets.PRIMARY RESPONSIBILITIES:Analyzes patient insurance to identify the correct insurance plan(s) was selected by reviewing the plan selection and any necessary documents or payor portals. Accurately documents all the proper steps to ensure accounts are worked correctly in a timely manner. Has the able to troubleshoot and resolve issues before they occur by collecting all the appropriate information to create useful error outputIdentifies billing errors and charge correction errors through research to resolve claim errors in a timely manner for the more complex eligibility tasks. This could include contacting payers, referring office/hospital, or patients to obtain medical insurance information.Follow the department directions, TIP sheets, procedure manuals, and departmental policy and procedures.Evaluate insurance payor set up with the billing system to confirm the eligibility payor connection logic. Assist management in optimizing the efficiency and quality of eligibility team.Assist with training and educating new and established staff membersQUALIFICATIONSREQUIRED QUALIFICATIONS:High school diploma or equivalent certification requiredDESIRED/PREFERRED QUALIFICATIONS:3 plus years of experience with eligibility related knowledgeKnowledge of understanding guidelines for Medicare/Medicaid, government plans, HMOs, and PPOsAt least one year of exceptional customer service skills3 plus years of denials management experienceStrong computer skills (including MS Word and Excel)Ability to think critically and resolve accounts with minimal supervisionHas a strong working knowledge of billing procedures, insurance reimbursement and guidelines preferably in a medical or anesthesia settingAbility to multitask, work in a team as well as independentlyMust be able to communicate effectively and professionally to patients, insurance companies along with co-workers and managementStrong oral and written communication skills preferredAbility to perform at a high level of productivity and qualityWork in collaboration with Team Lead to improve processesAbility to ensure confidentiality of sensitive information and maintain HIPAA compliance.Exceptional organization and time management skillsMust have professional and effective oral communications with co-workers, insurance representatives, clients, and patientsTotal RewardsSalary: $19-22 hourlyGenerous benefits package, including:Paid Time OffHealth, life, vision, dental, disability, and AD&D insuranceFlexible Spending Accounts/Health Savings Accounts401(k)Leadership and professional development opportunitiesEEO StatementNorth American Partners in Anesthesia is an equal opportunity employer.