Denials Specialist

7 days ago


Plano, Texas, United States LaSalle Network Full time
Denials Specialist Job Description

LaSalle Network is seeking a highly skilled Denials Specialist to join our team. As a Denials Specialist, you will play a critical role in optimizing our client's revenue cycle by identifying and resolving denied claims.

Key Responsibilities:
  • Conduct thorough reviews of denied claims to identify reasons for denials, including coding errors, documentation issues, and contractual limitations.
  • Research and analyze payer policies and guidelines to determine effective appeal strategies.
  • Prepare and submit accurate appeals to insurance carriers within established timeframes.
  • Track the status of appeals and follow up with payers to expedite the resolution process.
  • Identify trends in denials and collaborate with the coding and billing teams to implement corrective measures.
  • Maintain accurate records and documentation of all denials and appeals activities.
  • Collaborate with other departments to improve overall revenue cycle efficiency.
Requirements:
  • Bachelor's degree in healthcare administration, business administration, or a related field.
  • 2+ years of experience in healthcare revenue cycle management, with a focus on denials management.
  • Strong understanding of medical coding and billing practices.
  • Knowledge of payer regulations and reimbursement guidelines.
  • Excellent analytical and problem-solving skills.
  • Strong attention to detail and organizational abilities.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office Suite.

LaSalle Network is an Equal Opportunity Employer. We offer a comprehensive benefits package, including medical, dental, and vision coverage, as well as paid leave and sick leave. If you meet the above qualifications, we invite you to apply today.


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