Patient Accounting Specialist
4 weeks ago
**Denials Analyst/Patient Accounting Specialist**
**Department**: PFS - REVENUE RECOGNITION
**City**: Rancho Mirage, CA
**Hours Per Day**:8.00
**Responsibilities**:
- Research and resolve claim denials, ADR requests, and certifications.
- Submit and track appeals, noting trends, and providing monthly reports.
- Respond to audit requests from payors, including RAC.
- Maintain a library of payer reference material regarding pre-authorization, medical necessity, and documentation requirements.
**Key Duties**:
- Demonstrate compliance with the Code of Conduct and policies, reporting suspected violations.
- Analyze denied, underpaid, and unpaid claims; appeal underpaid and denied claims within filing periods.
- Identify, track, and report on denial trends.
- Maintain an appeals database for reporting outcomes and opportunities.
**Skills**:
- Strong analytical skills, proficient in Microsoft Windows, with an emphasis on Excel.
- Ability to prioritize workflow and attention to detail.
- Knowledge of CPT, HCPC, and ICD-10 coding requirements, with an emphasis on modifiers and diagnosis association.
- Working knowledge of LCDs, NCCI, MUE edits, and commercial, HMO, and Medicare Advantage claims.
**Education**:
- High school diploma or equivalent required; associate degree preferred.
**Licensure/Certification**:
- Certified coder or currently enrolled in a coding program preferred.
**Job Type**: Contract
Pay: $23.00 - $24.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
- Day shift
Work Location: On the road
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