Senior Medical Denials Specialist - Revenue Cycle

CAROLINA NEPHROLOGY, PA; Greenville (SC); Presencial; USD 25 000 - 29 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

401(k)

Paid Holidays

PTO

Dental/Health/Vision Insurance

Resumo da oferta

Carolina Nephrology, PA in Greenville, SC seeks an experienced Medical Denials Specialist to manage denied and outstanding professional claims across multiple queues, document research, and support timely reimbursement. The role requires independence and strong team collaboration in a growing practice.

Responsibilities include researching denials, meeting deadlines for appeals, and assisting with patient billing questions while contributing to department workflows and payer communications.

Qualificações

• Minimum of three years of direct medical denial management experience.
• Ability to research and resolve denied claims and prepare appeals.
• Knowledge of health insurance eligibility and coordination of benefits.
• Ability to read payer EOBs/ERAs and determine next steps.
• Strong organizational and time-management skills.

Responsabilidades

• Research and resolve denied claims by identifying root causes and submitting appeals or corrected claims.
• Monitor timely filing and appeal deadlines.
• Follow up on outstanding claims and prior appeals.
• Research claim status through payer portals and direct payer communication.
• Investigate denials related to eligibility, coverage dates, COB, and payer changes.
• Document denial research and payer communications in the patient account.
• Answer patient billing questions and assist with billing-related inquiries.

Conhecimentos

Medical denial management

Claims research

Payer communications

Team collaboration

Formação académica

High School Diploma

Ferramentas

Epic

Descrição da oferta de emprego

Carolina Nephrology, PA in Greenville, SC seeks an experienced Medical Denials Specialist to manage denied and outstanding professional claims across multiple queues, document research, and support timely reimbursement. The role requires independence and strong team collaboration in a growing practice.

Responsibilities include researching denials, meeting deadlines for appeals, and assisting with patient billing questions while contributing to department workflows and payer communications.