Patient Accounts Denial Specialist

3 weeks ago


Rockford, United States ROCKFORD GASTROENTEROLOGY ASSOCIATES LTD Full time

Description:
OVERALL SUMMARY:
Our Patient Accounts Department is seeking a skilled Denial Specialist to join our revenue cycle management team. The Denial Specialist plays a crucial role in analyzing and resolving insurance claim denials to ensure optimal reimbursement for medical services provided.
- Review and analyze denied insurance claims to identify the reasons for denial.
- Research and understand insurance policies, coding guidelines, and billing regulations to support claim appeals.
- Prepare and submit appeal letters and supporting documentation to insurance companies.
- Collaborate with medical coders, billing staff, and clinicians to gather necessary information for appeals.
- Monitor appeal status and follow up with insurance companies to expedite claim resolution.
- Identify trends in claim denials and recommend process improvements to minimize denials.
- Maintain accurate records of denial appeals, outcomes, and reimbursement.
- Other Duties determined by Manager.

Key Competencies:

- Problem-solving skills to identify root causes of claim denials.
- Ability to prioritize tasks and manage multiple appeals simultaneously.
- Team player with a collaborative approach to work.
- Adaptability to changing insurance policies and billing requirements.
- Strong organizational skills to maintain detailed appeal records.

**Requirements**:
QUALIFICATIONS:
A. Healthcare Administration, Business, or related field (or equivalent work experience).

B. Minimum of 2 years' experience in medical billing, claims processing, or denial management.

C. Familiarity with insurance verification, authorization, and appeals processes.

D. Strong analytical skills and attention to detail.

E. Excellent communication and negotiation abilities.

F. Proficiency in using billing software and electronic health records (EHR) systems.

G. Work at RGA office at 401 Roxbury Road in Rockford, IL 61107.



  • Rockford, United States Rockford Gastroenterology, Assc., LTD Full time

    Job DescriptionJob DescriptionDescription:OVERALL SUMMARY:Our Patient Accounts Department is seeking a skilled Denial Specialist to join our revenue cycle management team. The Denial Specialist plays a crucial role in analyzing and resolving insurance claim denials to ensure optimal reimbursement for medical services provided.Review and analyze denied...


  • Rockford, United States Mercyhealth Full time

    Overview Insurance Billing Rep, Patient Accounts Follow Up, Days, 80 Hrs / wks Location: Rockton Ave; Rockford, IL Hybrid and flexible work schedule opportunities avaliable.  Responsible for ensuring claims are resolved with third party payers in a reasonable time frame as defined by Revenue Cycle metrics. This includes working claims that fail...


  • Rockford, United States ROCKFORD GASTROENTEROLOGY ASSOCIATES LTD Full time

    Description: **Overall Summary**: RGA is seeking a detail-oriented and experienced Prior Authorization Specialist Group Lead to join our team. In this role, you will be responsible for obtaining prior authorizations from insurance companies for medical procedures, medications, and services to ensure timely and accurate reimbursement for our patients. Oversee...


  • Rockford, United States Rockford Gastroenterology, Assc., LTD Full time

    Job DescriptionJob DescriptionDescription:Overall Summary:RGA is seeking a detail-oriented and experienced Prior Authorization Specialist to join our team. In this role, you will be responsible for obtaining prior authorizations from insurance companies for medical procedures, medications, and services to ensure timely and accurate reimbursement for our...


  • Rockford, United States Rockford Gastroenterology, Assc., LTD Full time

    Job DescriptionJob DescriptionDescription:Overall Summary:RGA is seeking a detail-oriented and experienced Prior Authorization Specialist to join our team. In this role, you will be responsible for obtaining prior authorizations from insurance companies for medical procedures, medications, and services to ensure timely and accurate reimbursement for our...


  • Rockford, United States Mercyhealth Full time

    Overview: - Patient Access Specialist, Days, 80 Hrs / 2 wks - Location: Rockton Ave Campus; Rockford, IL. Hybrid schedule opportunities available after probationary period. - Responsible for correctly prioritizing and completing all steps of the scheduling, referral management, authorization, verification and registration process prior to patients receiving...


  • Rockford, United States Mercyhealth Full time

    Overview: - Patient Access Specialist, Days, Rockford, 80 Hrs / 2 wks - Location: Rockton Ave Campus; Rockford, IL - Hybrid and flexible work schedule opportunities available after probationary period. Responsible for correctly prioritizing and completing all steps of the scheduling, referral management, authorization, verification and registration process...


  • Rockford, United States Mercy Health Full time

    Overview: Patient Access Specialist, Days, Rockford, 80 Hrs / 2 wks Location: Rockton Ave Campus; Rockford, IL Hybrid and flexible work schedule opportunities available after probationary period. Responsible for correctly prioritizing and completing all steps of the scheduling, referral management, authorization, verification and registration process prior...


  • Rockford, United States Mercy Health Full time

    Overview: Patient Access Specialist, Days, Rockford, 80 Hrs / 2 wks Location: Rockton Ave Campus; Rockford, IL Hybrid and flexible work schedule opportunities available after probationary period. Responsible for correctly prioritizing and completing all steps of the scheduling, referral management, authorization, verification and registration process prior...


  • Rockford, United States Orthoillinois Full time

    Department: Billing Reports To: Revenue Cycle Manager FLSA: Non Exempt **Job Purpose**: The Reimbursement Specialist is responsible for reviewing direct and indirect patient and insurance payments for posting into practice management software, researching credit accounts and reconciling payment activity. **Primary Duties and Responsibilities**: Posts...


  • Rockford, United States Rockford Gastroenterology, Assc., LTD Full time

    Job DescriptionJob DescriptionDescription:Overall Summary:RGA is seeking a detail-oriented and experienced Prior Authorization Specialist Group Lead to join our team. In this role, you will be responsible for obtaining prior authorizations from insurance companies for medical procedures, medications, and services to ensure timely and accurate reimbursement...


  • Rockford, United States SwedishAmerican Full time

    POSITION SUMMARY: Audits charts for appropriate coding documentation practices. Maintains current knowledge of charge reporting of related CPT and ICD-10 systems. Provides regular education programs to providers and other professional staff. Reviews inpatient, surgery center and outpatient records and assigns appropriate CPT and ICD10 diagnosis....


  • Rockford, United States OrthoIllinois Full time

    **Department**: Infusionist **Reports To**: Manager, Rheumatology & Infusion **FLSA**: Non-Exempt **Job Purpose**: The Prior Authorization Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers, and specialty pharmacies. The Rheumatology Prior...


  • Rockford, United States Mercyhealth Full time

    Overview: - Cash Poster, Patient Financial Services, Days, 80 Hrs/2 wks - Location: Rockton Ave Campus; Rockford, IL. - Schedule: Monday - Friday; Hybrid remote and flexible work schedule available after training period Responsible for timely and accurate posting of payments and adjustments related to patient accounts receivable transactions. Assumes...


  • Rockford, United States Waldom Electronics Full time

    **Job Title**: Accounts Payable Specialist **Job Type**: Hourly **Department**: Finance / Accounting **Reports to**: A.P. Manager **Based at**: Waldom Electronics USA in Rockford, IL **Position Overview** The primary responsibility of Accounts Payable is to process vendor invoices for payment. If there are issues, they must communicate with the...


  • Rockford, Illinois, United States University of Wisconsin Medical Foundation Full time

    Work Schedule : 60% FTE, 24 hours per week. Shifts scheduled Monday through Friday between the hours of 8:00 AM - 4:30 PM. Hours may vary based on the operational needs of the department. Pay : Pay starts at $19.32 per hour, work experience that is relevant to the position will be taken into consideration when determining the starting base pay. Be part...


  • Rockford, Illinois, United States University of Wisconsin Medical Foundation Full time

    Work Schedule : 60% FTE, 24 hours per week. Shifts scheduled Monday through Friday between the hours of 8:00 AM - 4:30 PM. Hours may vary based on the operational needs of the department. Pay : Pay starts at $19.32 per hour, work experience that is relevant to the position will be taken into consideration when determining the starting base pay. Be part...


  • Rockford, Illinois, United States Waldom Electronics Full time

    Job DescriptionJob DescriptionSalary: Starting at $18 per hourJob Title: Accounts Payable SpecialistJob Type: HourlyDepartment: Finance / AccountingReports to: A.P. ManagerBased at: Waldom Electronics USA in Rockford, ILPosition OverviewThe primary responsibility of Accounts Payable is to process vendor invoices for payment. If there are issues, they must...


  • Rockford, United States Waldom Electronics Full time

    Job DescriptionJob DescriptionSalary: Starting at $18 per hourJob Title: Accounts Payable SpecialistJob Type: HourlyDepartment: Finance / AccountingReports to: A.P. ManagerBased at: Waldom Electronics USA in Rockford, ILPosition OverviewThe primary responsibility of Accounts Payable is to process vendor invoices for payment. If there are issues, they must...


  • Rockford, United States University of Wisconsin Medical Foundation Part time

    Work Schedule : 60% FTE, 24 hours per week. Shifts scheduled Monday through Friday between the hours of 8:00 AM - 4:30 PM. Hours may vary based on the operational needs of the department. Pay : Pay starts at $19.32 per hour, work experience that is relevant to the position will be taken into consideration when determining the starting base pay. Be part...