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Denials Management Specialist

4 months ago

Lombard, United States Seema Elahi MD Inc Full time
Job DescriptionJob Description

The Denials Management Specialist is responsible for analyzing denied claims, preparing and submitting appeal letters, and working with insurance companies to resolve denied claims efficiently.

Key Responsibilities:

- Analyze denied claims to identify reasons for denial.

- Prepare and submit detailed appeal letters to insurance companies.

- Follow up with insurance companies to resolve denied claims.

- Collaborate with billing and coding teams to ensure accurate claim submissions.

- Maintain detailed records of denial reasons, appeals submitted, and outcomes.

- Identify trends in denials and provide feedback to prevent future occurrences.

- Communicate with patients and healthcare providers regarding the status of denied claims.

- Stay updated on changes in insurance policies and guidelines.

Qualifications:

- Bachelors degree in Healthcare Administration, Business, or a related field.

- 3+ years of experience in medical billing, coding, or denials management.

- Strong understanding of insurance policies, guidelines, and regulations.

- Excellent analytical and problem-solving skills.

- Proficiency in medical billing software and Microsoft Office Suite.

- Strong communication and negotiation skills.

- Attention to detail and the ability to work independently.