Denial Resolution Specialist, Outpatient Behavioral Health - Harrington Southbridge Campus - 40 hours, Days
On-siteSouthbridge, Massachusetts, United States
Job Summary
Review, analyze, and initiate action for denial resolution by communicating with payers, hospital departments, and patients. Conduct authorization research, rebill, and adjust account balances using correct transaction codes. Correspond with third parties to obtain information required for resolution, troubleshoot payer issues using reference materials, and submit appeals electronically or via paper following established timelines. Document all actions taken, next steps, and processing timelines while adhering to Federal, State, and Hospital guidelines. Maintain an organized work environment, participate in cross-training, and contribute to process improvements within the Billing Revenue Cycle Management department.
Required Qualifications
- High School diploma
- Previous Revenue Cycle knowledge in one of the following areas including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party Reimbursement
- Ability to perform assigned tasks efficiently and in timely manner
- Ability to work collaboratively and effectively with people
- Exceptional communication and interpersonal skills
Desired Qualifications
- One or more years of experience in health care billing functions and with EPICS experience
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.