Denials Specialist/ Denials Coordinator/ Denials

3 weeks ago

Rancho Mirage, United States MedRecruit LLC Full time

Job Details:

- Position: Denials Analyst
- Location: Rancho Mirage, CA
- Duration: 13 Weeks Contract
- Shift: 8 Hour Shift

**Responsibilities**:

- Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
- Analyze denied, underpaid and unpaid claims. Appeal underpaid and denied claims within timely filing periods.
- Identify, track and report on denial trends.
- Maintain an appeals data base to identify and report outcomes and opportunities
- Identify any billing and/or coding trends resulting in denials and report to the Coding manager.
- Identify any other trends resulting in denials and report to Manager.
- Attend all available coding and appeals related seminars as available
- All other duties as assigned

**Requirements**:

- Required: Minimum of two years of Professional Billing with an emphasis in Managed Care denial follow up and appeals processing Prior hospital billing experience a plus.
- Required: High School diploma or equivalent
- Strong Analytical skills, Proficient in Microsoft Windows with emphasis on Excel.
- Ability to prioritize and coordinate workflow and attention to detail.
- Knowledge of CPT, HCPC and ICD 10 coding requirements with emphasis on modifiers and diagnosis association.
- Working knowledge of LCD’s, NCCI and MUE edits as well as a general knowledge of Commercial, HMO, and Medicare Advantage claims, authorization and documentation requirements.

**Job Types**: Full-time, Contract

Pay: $21.00 - $23.00 per hour

Expected hours: 40 per week

Schedule:

- 8 hour shift
- Day shift
- Monday to Friday

**Experience**:

- Denials Coordinator/Analyst/Specialist: 2 years (preferred)
- Healthcare Facility: 1 year (preferred)

Ability to Commute:

- Rancho Mirage, CA 92270 (preferred)

Work Location: In person

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