Denials Representative – 4726

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• Career Growth Opportunities
• Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment.
• 401K program (Discretionary matching funds available)
• GENEROUS Personal time off
• Eight Paid Holidays per year
• Quarterly incentive plans
• Business casual dress code
• Flexible work schedule

JOB DESCRIPTION OVERVIEW:

This position is responsible for reviewing various carrier denials at their assigned Billing Group. Maintains accuracy and production to ensure invoices are being processed efficiently.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Reviews ETM task list assignment, comments, and rebills claim as necessary.
• Reviews denials to determine appropriate action based on carrier requirements.
• Assembles and forwards appropriate documentation to the senior representative for carrier related issues.
• Reviews carrier provider manuals for billing updates as needed.
• Reports any consistent errors found during review that affect claims from being processed correctly.
• Participates in department meetings with Accounts Receivable Team
• Turns to Senior/Supervisor for unusual circumstances that may include write-offs, fee schedules, claims, etc.
• Performs any and all duties as directed by Senior Representative, Supervisor, and Accounts Receivable Manager

Job Requirements:

EXPERIENCE / SKILLS:

• One-year medical billing experience
• Knowledge of physician billing policies and procedures
• Computer literate
• Ability to work in a fast-paced environment.
• Excellent organizational skills
• Ability to work independently.

EDUCATION:

• High school diploma or equivalent.

WORKING CONDITIONS:

• This job will be performed in a well-lighted and well-vented environment. Requires constant sitting tolerance. Involves extensive computer use.
• Set in a pleasant, high-volume, fast-paced office environment.
• Overtime may be required and can be mandated by Management.

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