<p>Position Summary</p> <p>This position is 100% remote. We will only consider remote applicants residing in the following US states - AL, AZ, CT, DE, FL, GA, IN, KS, KY, LA, MD, MI, NC, PA, RI, SC, VA, WV, and WI.</p> <p>The Denial Management Specialist is responsible for denial and AR management for the department as defined by their supervisor/manager.</p> <p>Minimum Requirements</p> <p>Education</p> <ul> <li>High School Diploma or equivalency </li></ul> <p>Experience</p> <ul> <li>4 years' experience in medical billing, setting with exposure to denials, appeals, insurance collections and related follow-up. </li><li>Must have good knowledge of ICD9 and CPT-4 coding </li><li>Must have a good working knowledge with insurance explanation of benefits (EOB) and comprehensive understanding of remittance and remark codes. </li><li>Be familiar with multiple payer requirements for claims processing </li><li>Solid skills with Microsoft office with a focus on Excel and Word. </li><li>Good Communication Skills </li></ul> <p>License/Registration/Certifications</p> <ul> <li>N/A </li></ul> <p>Preferred Requirements</p> <p>Preferred Education</p> <ul> <li>Associates or Bachelor's degree in a Healthcare related field. </li></ul> <p>Preferred Experience</p> <ul> <li>Focused denials and appeals management experience. </li></ul> <p>Preferred License/Registration/Certifications</p> <ul> <li>CPC and/or CPC-H certification </li></ul> <p>Core Job Responsibilities</p> <ul> <li>Research and resolve all outstanding denials within workque and complete all necessary follow up within a timely and accurate manner </li><li>Identify all denial trends and provide education of steps to prevent future avoidable denials. </li><li>Initiate/manage all insurance appeals in a timely manner </li><li>Manage outstanding AR related to denials. </li><li>Communicate all denial trends and denial increases to direct supervisor/manager in order to positively affect the volume of denials </li><li>Organize the workflow to ensure that denials are worked according to departmental policy and standards. </li><li>Manage correspondences and any ADR requests as defined within department workflow procedure to ensure timeless and accuracy of response. </li><li>Complete special projects as assigned by Supervisor/Manager </li><li>Prepare/attend AR denial meetings as required. </li></ul>