Healthcare Claims Denials Specialist

2 weeks ago


Springfield, Illinois, United States CenterWell Home Health Full time
About the Role

We are seeking a skilled Healthcare Claims Denials Specialist to join our team at CenterWell Home Health. As a key member of our operations team, you will play a critical role in ensuring the timely and accurate processing of healthcare claims.

Key Responsibilities
  • Coordinate claim activities and designated agencies to ensure timely reimbursement of receivables.
  • Research, resolve, and prepare claims that have not passed payer edits daily.
  • Determine and initiate action to resolve rejected invoices.
  • Analyze each agency's outstanding monthly accounts receivable and process claims to obtain zero balances.
  • Clear payment variances, resolving differences, and initiating corrective action.
  • Guide and support agency personnel in all aspects of insurance and non-Medicare claims processing.
  • Prepare input data forms to update computer systems.
  • Review and communicate with agencies to educate them about expectations for clean claims.
Requirements
  • High School Diploma or equivalent.
  • Minimum of two years medical claims processing experience.
  • Knowledge of healthcare collection procedures and microcomputer software/hardware.
  • Effective analytical and communication skills.
About Us

CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery, or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers working together to help patients rehabilitate, recover, and regain their independence.

As a Humana company, we offer stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ over 30,000 clinicians who are committed to putting health first for our teammates, patients, communities, and company.



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