Claims Examiner
3 months ago
Health Advocates Network ishiring a Denials Analyst (2 Years Exp Req) This is a full-time contract position at a nationally recognized hospitallocated in Folsom, CA.
- Pay Rate: $24.00/hour
- Shift: Days (8hrs)
- Start Date: ASAP
- Contract Length: 13 weeks
Job Summary: Responsible for researching and resolving claim denials, ADR requests, and certs, submitting and tracking appeals, noting trends, and providing monthly reports. Respond to audit requests (including RAC) from payors. Maintains a Library of Payer reference material regarding requirements for pre-authorization, medical necessity, and documentation requirements. Works with the Revenue Cycle stakeholders (e.g. Admitting, Coding, Provider Liaisons, etc.) to provide information related to denials and opportunities for future denials.
Denials Analyst Qualification and Requirements:
- High school diploma or equivalent.
- Minimum of two (2) years of Professional Billing with an emphasis on Managed Care denial follow-up and appeals processing - prior hospital billing experience is a plus.
- 3-5 years of Patient Accounting in a high-volume environment preferred.
- Knowledge of CPT, HCPC, and ICD 10 coding requirements with emphasis on modifiers and diagnosis association.
- Certified coder or currently enrolled in a coding program
- Working knowledge of LCDs, NCCI, and MUE edits as well as a general knowledge of Commercial, HMO, and Medicare Advantage claims, authorization, and documentation requirements.
- Proficient in computer skills including Microsoft Office Applications.
Benefits We Offer:
- Competitive pay rates, Referral opportunities, Comprehensive health, prescription, dental, vision, life, and disability plans, and more
To apply for this job now or to find out more about other opportunities with Health Advocates Network, visit www.hanstaff.com. We can provide you with unparalleled access to exciting career opportunities.
Health Advocates Network, Inc. is an equal opportunity employer. All qualified applicants shall receive consideration for employment without regard to any legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies.
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