Denial Collections Specialist
Company: Francisan Health
Posted on: May 1, 2021
WHAT WE NEED Persistent, organized financial support WHO WE ARE
LOOKING FOR Some people love getting to the bottom of things --
chasing down claims, resolving accounts, digging through the
details to identify discrepancies and needs. Yes, we're talking
about people who love collections. And it takes a love of getting
into the details to do this job well. Do you have top notch
customer service and data entry skills? Are you good at following
through on inquiries? Are you accurate and organized? We'd love to
talk to you about working here. WHAT YOU WILL DO
- Analyze reports and use software to track, trend and identify
root causes of denials; offer suggestions for process improvement
to resolve denial issues, supported by documentation and data.
- Collaborate with other departments to align interdepartmental
functioning, goals, and expectations.
- Ensure all clinical denials assigned to Clinicians, Patient
Access and/or HIM denial staff are acknowledged in a timely manner
and appropriate follow-up action is taken as defined by the
- Conduct follow-up with insurance carriers, physicians, and
other stakeholders that can validate and assist with actions and
information needed in order to properly review, dispute or appeal
denial until a determination is made to conclude the appeal.
- Ensure that follow-up responses on denied claims occur on a
timely basis and adhere to contractually binding conditions.
- Resubmit overturned denials as warranted and monitor denial
resubmissions for payment; resubmit claims using the denial program
re-bill requests feature, ensuring all modifications to the account
are reflected on the claim form.
- Ensure compliance with all state and federal billing
- Perform recoupments to include investigating claim and payment
history to see if the appeal is warranted.
- Review rejected claims based on NPI denials. WHAT IT TAKES TO
- Prior Patient Accounting experience.
- Understanding of billing and collection systems.
- Customer service skills.
- Adapt to high volume and high stress areas.
- Concentrate for long periods.
- Critical thinking skills.
- Critically evaluate and analyze information.
- Effectively communicate verbally and in writing.
- Knowledge of HIPAA Guidelines.
- Maintain a positive approach, work cooperatively with others,
and demonstrate a constructive response to criticism.
- Knowledge of Managed Care requirements under the
Medicare/Medicaid and other third party payor programs.
- Proficient in Microsoft Office Applications. EQUAL OPPORTUNITY
EMPLOYER It is the policy of Franciscan Alliance to provide equal
employment to its employees and qualified applicants for employment
as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the
event local, state or Federal ordinances that violate its values
and the free exercise of its religious rights. Franciscan Alliance
is committed to equal employment opportunity.
Keywords: Francisan Health, Greenwood , Denial Collections Specialist, Accounting, Auditing , Greenwood, Indiana
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