Parsippany, New jersey
Denials Coordinator Job Opening in Parsippany, New jersey - Job purpose
Our Denial Management Recovery Services division is an integral part of our company's success. The Team is responsible for collecting outstanding insurance balances left open due to technical and clinical denial activity. The analyst should have the following: excellent communication skills; excellent critical thinking skills; excellent client relationship skills; thorough understanding of the revenue cycle including third party payer requirements.
Duties and responsibilities
Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.
Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies
Review denial activity and classify into correct denial categories
Generate appeal templates and refer to clinical team
Analyze completed appeal package to ensure completion and verify correct payer information is included
Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results.
Identify and report denial trends
Initiate low dollar appeals when necessary
Basic knowledge of healthcare claims processing including: ICD-9, CPT, and HCPC codes, as well as UB-04
Ability to analyze, identify and resolve issues causing payer payment delays
Act cooperatively and courteously with patients, visitors, co-workers, management and clients.
Maintain confidentiality at all times
Maintain a professional attitude
Understand and comply with Information Security and HIPAA policies and procedures at all times
Use, protect and disclose patients? protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Report any security or HIPAA violations or concerns to the HIPAA Officers in a timely fashion
Qualifications
3 years? experience in Commercial insurance collections, including submitting and following up on claims
Experience in Hospital/Facility billing
Ability to work well individually and in a team environment.
Proficiency with MS Office
Strong communication skills/oral and written
Strong organizational skills
Job Type: Full-time
Required experience:
commercial isurance collections: 1 year
hospital/physician billing: 1 year
Required license or certification:
Medical Billing and Coding
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