Revenue Cycle Denials Specialist

1103 Team Member Services; United States; In loco; USD 28.000 - 51.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, Dental, Vision Insurance

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave

Descrizione del lavoro

AdventHealth in Altamonte Springs, FL is seeking a denials management specialist to review and appeal denials across service lines. You will research payer portals, analyze reason codes, and collaborate across departments to gather documentation for accurate rebilling.

The role requires 3+ years in denials management or revenue cycle, strong analytical and communication skills, and proficiency with Epic EHR. This is a day shift, full-time position with comprehensive benefits.

Competenze

• Understanding of revenue cycle processes including charge capture and billing regulations.
• Knowledge of CPT, HCPCS, ICD codes, UB-04 Revenue Codes, and modifiers.
• Ability to navigate the electronic medical record and correlate services to charges.
• Strong problem-solving, multi-tasking, and attention to detail.

Mansioni

• Review and appeals denials across all service lines system-wide.
• Researches account histories, payer portals, and payment records to determine appropriate appeal strategies.
• Evaluates denial types including charge audit, charge capture, authorization, timely filing, and payer policy denials.
• Recommends charge corrections and prepares accounts for rebilling as appropriate.
• Collaborates with pre-access, patient financial services, revenue integrity, utilization management, and clinical departments to gather supporting documentation.
• Provides reports, education, and training on denial trends and recommended remediation strategies.
• Educates stakeholders on proper documentation, payer processes, and policies with a denial prevention focus.
• Drafts and submits written and verbal appeals using clear, concise terminology.
• Researches root causes, collects supporting documentation, and adjusts accounts based on internal and external findings.
• Utilizes multiple IT systems to compile comprehensive clinical and financial information for appeals.
• Escalates identified claim issues and trends to appropriate leadership or payer contacts.
• Performs other duties as assigned

Conoscenze

Revenue cycle knowledge

CPT/HCPCS/ICD knowledge

Microsoft Excel

Payer portals navigation

Written communication

Independent work

Analytical thinking

Formazione

High School Diploma or Equivalent

Bachelor's degree preferred

Strumenti

Epic EHR

Microsoft Office

Descrizione del lavoro

AdventHealth in Altamonte Springs, FL is seeking a denials management specialist to review and appeal denials across service lines. You will research payer portals, analyze reason codes, and collaborate across departments to gather documentation for accurate rebilling.

The role requires 3+ years in denials management or revenue cycle, strong analytical and communication skills, and proficiency with Epic EHR. This is a day shift, full-time position with comprehensive benefits.