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Denial Specialist

4 months ago

Colorado Springs, United States Envision Radiology Full time
Envision Radiology is looking for a Remote Full Time Denial Specialist to join our teamOpen to AL, AZ, CO, FL, ID, LA, MO, NE, NC, OK, TX, UT, VA, WA & WI Markets.
40 hours/week Monday - Friday | Position Pay Range Pay Range: $18.50 - $22.25

Summary/Objective:

The Denial Specialist is responsible for working with insurance companies to perform denial resolution on outstanding claims.

Essential Functions

1. Reviews denied claims to determine appropriate course of action.

2. Interacts with payers to determine true reason for denial and inquire on what corrections need to be made.

3. Works with the coding team when necessary to make coding changes to submit corrected claims or appeals.

4. Creates a case for the appeal stating the deficiencies and the resolution.

5. Takes ownership for the quality and timeliness of work and achieves the desired results.

6. Stays current with payer trends for submitting corrected claims and appeals.

7. Maintains strict confidentiality regarding Patient Health Information (PHI) as well as follows HIPAA regulations.

8. Identifies billing trends (i.e. claim format, denials, and payment issues).

9. Other duties as assigned.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Competencies

1. Financial Management

2. Ethical Conduct

3. Thoroughness

4. Stress Management/ Composure

Supervisory Responsibilities

This position has no supervision responsibilities.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to use hands and fingers to handle, feel or operate objects, tools or controls, and reach with hands and arms. The employee is frequently required to talk and hear.

Travel

No travel is expected for this position.

Job Qualifications

Minimum Qualifications/Experience:

  • Detail oriented, self-motivated, a problem solver and a team player
  • Minimum of 2 years' experience working in medical billing denials
  • Knowledge of EOBs
  • Ability to navigate multiple computer screens and browsers quickly and accurately
  • Ability to excel in a very fast-pace team environment
  • Ability to continuously "exceed" company and customer expectation
  • Strong communication skills & professional demeanor
Education/Certifications:
  • Minimum of High School diploma or equivalent (GED)-Continuing education preferred
Additional Eligibility Qualifications

None required for this position.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Compliance

Adheres to Envisions Code of Conduct and Compliance Policies and attends annual Compliance training as set forth by the Company.

Company Benefits

Below is a list of benefits that are offered to employees, once eligibility is met.
  • Health Benefits: Medical/Dental/Vision/Life Insurance
  • Company Matched 401k Plan
  • Employee Stock Ownership Plan
  • Paid Time Off + Paid Holidays
  • Employee Assistance Program


OSHA Exposure Rating: 1

It is reasonably anticipated NO employees in this job classification will have occupational exposure to blood and other potentially infectious body fluids.

Envision Radiology is an equal opportunity employer (M/F/D/V). We recruit, employ, train, compensate and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by application federal, state or local law.

Applications accepted until 6/7/24