Healthcare Claims Denials Specialist
23 hours ago
We are seeking a skilled Healthcare Claims Denials Specialist to join our team at CenterWell Home Health. As a key member of our care team, you will play a critical role in ensuring the timely reimbursement of receivables and resolving claims that have not passed payer edits.
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.
- 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.
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 - all working together to help patients rehabilitate, recover, and regain their independence.
As part of Humana Inc., CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities, and company.
BenefitsHumana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
Among our benefits, Humana provides medical, dental, and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance, and many other opportunities.
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