Current jobs related to Denial Management Specialist - Oak Brook, Illinois - Nationwide Credit & Collection Inc.

  • Reimbursement Specialist

    4 weeks ago

    Oak Park, Illinois, United States West Suburban Medical Center Full time

    At West Suburban Medical Center, we are committed to providing exceptional patient care and service. As a Reimbursement Specialist, you will play a critical role in ensuring accurate reimbursement for our patients.Job SummaryThe Reimbursement Specialist is responsible for reviewing Explanation of Benefits (EOBs), identifying underpayments, and processing...

  • Billing Claims Specialist II

    4 weeks ago

    Oak Brook, Illinois, United States Advocate Health Full time

    Job SummaryAs a Billing Claims Specialist II at Advocate Health, you will be responsible for daily claims submissions to the appropriate responsible parties. You will act as a resource person, assisting teams with more complex issues, and work with team members to facilitate problem resolution and provide training. You may be involved in quality audit...

  • Wealth Management Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Soltis Investment Advisors Full time

    About the RoleSoltis Investment Advisors is seeking a skilled Wealth Management Specialist to join our team. As a key member of our wealth management team, you will be responsible for managing a portfolio of clients and providing ongoing service to ensure high levels of client retention.Key ResponsibilitiesManage a portfolio of over 100 clients.Provide...

  • Food Preparation Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Bottleneck Management Full time

    Job Summary:We are seeking a skilled Prep Cook to join our team at Bottleneck Management. As a Prep Cook, you will play a critical role in preparing and maintaining assigned par levels of food items, producing all proteins, sauces, dressing, and stocks from scratch, and upholding the origination of all recipes to provide our guests with the best possible...

  • Insurance Claims Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Extremity Care Full time

    Job Title: Insurance Claims SpecialistJob Summary: We are seeking a highly skilled Insurance Claims Specialist to join our team at Extremity Care. As an Insurance Claims Specialist, you will be responsible for verifying patient eligibility and benefits, managing insurance claims, and ensuring accurate and efficient processing of insurance requests.Key...

  • IT Support Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Collegis LLC Full time

    The IT Support Specialist position at Collegis Education is a dynamic role that requires a proactive and data-driven approach to providing exceptional customer and managed IT services to our clients and employees.Located at our Oak Brook, IL office, this opportunity involves providing computer support to students, faculty, and employees, including PC,...

  • IT Support Specialist

    1 month ago

    Oak Brook, Illinois, United States Collegis LLC Full time

    Job Title: IT Support SpecialistCollegis Education is seeking a highly skilled and experienced IT Support Specialist to join our team. As a key member of our IT department, you will be responsible for providing exceptional customer and managed IT services to our clients and employees.Key Responsibilities:Provide computer support to students, faculty, and...

  • Insurance Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Advocate Aurora Health Full time

    Key Responsibilities:As an Insurance Verification Specialist - Home Infusion with Advocate Aurora Health, you will play a crucial role in ensuring seamless insurance coverage for our patients. Your primary responsibilities will include obtaining and verifying patient and insurance information, applying your knowledge of government and third-party payer...

  • Marketing Automation Specialist

    4 weeks ago

    Oak Brook, Illinois, United States The Chamberlain Group Inc Full time

    Job SummaryChamberlain Group is seeking a highly skilled Marketing Automation Specialist to join our Marketing team. As a key member of our Demand Generation team, you will be responsible for developing and executing integrated cross-channel campaigns to drive customer engagement, conversion, and retention.Key Responsibilities Develop and implement CRM...

  • Sales Support Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Mauser Packaging Solutions Full time

    Job Summary:We are seeking a highly skilled Sales Support Specialist to join our team at Mauser Packaging Solutions. As a Sales Support Specialist, you will provide detailed, high-level support to Regional Sales Representatives and Regional Managers, acting as a liaison between Sales Team, Customers, and Internal Departments.Key Responsibilities:Provide...

  • Marketing and Community Engagement Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Portillo's Full time

    Marketing and Community Engagement SpecialistAt Portillo's, we're looking for a skilled Marketing and Community Engagement Specialist to join our team. As a key member of our marketing team, you'll be responsible for developing and implementing local marketing strategies to drive sales and community engagement.Key Responsibilities:Develop and execute local...

  • Compliance Specialist

    1 month ago

    Oak Brook, Illinois, United States RHM Staffing Solutions Full time

    Job OverviewRHM Staffing Solutions is seeking a highly organized and detail-oriented Compliance Specialist to join our team. The ideal candidate will have a strong understanding of regulatory compliance and be able to ensure that clients and contractors are onboarded correctly.Key Responsibilities:Onboard contractors and clients into Payroll and Billing...

  • Marketing Solutions Delivery Specialist

    1 month ago

    Oak Brook, Illinois, United States Portillo's Full time

    Job Title: Marketing/IT Field Solutions Delivery SpecialistThe Marketing/IT Field Solutions Delivery Specialist will collaborate with key stakeholders from the Marketing Team to develop, test, and implement technology solutions that reduce friction, simplify operational processes, and digitize administration and restaurant control functions. This role is...

  • Cash Posting Specialist

    3 weeks ago

    Oak Brook, Illinois, United States Nephrology Associates of Full time

    About Nephrology Associates ofNephrology Associates of is the nation's largest Nephrology practice, providing excellence in specialty kidney care for over 50 years. Our nephrology practices are primarily operated in northern Illinois and throughout northern and central Indiana, with additional locations in New Jersey.Our Scope of CareOur scope of care and...

  • Internal Communications Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Advocate Aurora Health Full time

    Job SummaryAdvocate Aurora Health is seeking a highly skilled Internal Communications Specialist to join our team. As a key member of our communications team, you will be responsible for developing and implementing internal communication and engagement strategies that support the organization's key priorities. Key ResponsibilitiesDevelop and manage internal...

  • IT Support Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Collegis LLC Full time

    Job DescriptionCollegis Education is a marketing and technology education solutions company that offers industry-leading services for colleges and universities of every size in every sector. Our team is dedicated to empowering institutions to make a broader impact by providing insights that help grow enrollments, improve student outcomes, and optimize...

  • Senior Brand Marketing Specialist

    3 days ago

    Oak Brook, Illinois, United States Ace Hardware Corporation Full time

    About the RoleThe Senior Brand Marketing Specialist – Advertising & Media will support Ace's national creative advertising and brand media efforts across all channels and act as the primary day-to-day lead with Ace's creative advertising agency and secondary with the media agency.Key ResponsibilitiesLead the creative advertising agency and internal teams...

  • Fund Accounting Specialist

    4 weeks ago

    Oak Brook, Illinois, United States E78 Partners Full time

    Are you a detail-oriented accounting professional looking for a challenging role in the alternative investment industry? E78 Partners is seeking a highly skilled Fund Accounting Specialist to join our growing team.ResponsibilitiesProvide fund administration services to Private Equity, Venture Capital, SBIC, and Real Estate FundsServe as client lead for...

  • Paralegal Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Insight Global Full time

    We are seeking a skilled Paralegal Specialist to join our team at Insight Global. As a key member of our legal team, you will assist attorneys in preparing for federal immigration proceedings and state court criminal cases.Key Responsibilities:Conduct client interviews and gather necessary documentationDraft legal documents, including affidavits, motions,...

  • Facilities Maintenance Specialist

    4 weeks ago

    Oak Brook, Illinois, United States Administrative Portillos Hot Dogs LLC Full time

    Job SummaryWe are seeking a skilled Facilities Maintenance Specialist to join our team at Administrative Portillos Hot Dogs LLC. As a key member of our operations team, you will be responsible for ensuring the smooth operation of our restaurant facilities, including equipment maintenance, repairs, and preventative maintenance.Key ResponsibilitiesPerform...

Denial Management Specialist

1 month ago

Oak Brook, Illinois, United States Nationwide Credit & Collection Inc. Full time
Job Title: Denial Management Specialist

We are seeking a highly skilled Denial Management Specialist to join our team at Nationwide Credit & Collection Inc. in Oak Brook, IL.

Key Responsibilities:

  • Investigate insurance denials to identify necessary actions to resolve claims, including calls to payors and use of multiple computer systems.
  • Analyze EOBs at a claim level and correct claims based on denials and rebills using payor-approved processes.
  • Determine the need for payor appeal of a claim and send appeals via payor portal or payor-approved appeal letters, monitoring appeals for resolution.
  • Adjust accounts appropriately, using correct denial codes, and recognize when additional assistance is needed to resolve denials, escalating accordingly.
  • Spot trends and report them to management, working a minimum of 45 accounts per day with 95% accuracy.
  • Communicate effectively both verbally and in writing, detailing all activities and findings in accordance with established policies and procedures.
  • Perform special projects or other duties as assigned, maintaining strictest confidentiality and adhering to all employer and government privacy standards.

Requirements:

  • High school graduate or equivalent.
  • 2 years previous experience in medical revenue cycle.
  • Minimum 1 year EPIC enterprise experience.
  • Familiarity with Excel and demonstrated problem-solving ability.
  • Able to work effectively in a remote setting and possess strong organizational skills.

Preferred Qualifications:

  • 2 years previous experience in medical denial management.
  • Minimum of 1-year recent Epic experience with the Resolute/Billing module.
  • Knowledge and experience in working with healthcare insurance portals.
  • A good understanding of CPT, modifiers, HCPC, ICD-10, and medical terminology.
  • Working knowledge of Medicare, Medicaid, and Commercial payor fee schedules and reimbursement documentation.

Skills:

  • Ability to effectively prioritize and execute tasks.
  • Ability to grasp and apply information quickly and accurately.
  • Ability to make decisions based on available information and within scope of their authority.
  • Excellent customer service skills and telephone interaction skills.
  • Excellent keyboarding skills, typing, and 10-key.
  • Proficiency with MS Word and Excel.
  • Good work ethic.