Denials Specialist

5 hours ago

Rancho Mirage, California, United States RemX Full time
Job Summary

RemX is seeking a highly skilled Denials Analyst to join our team in Rancho Mirage, CA. This is a 13-week contract opportunity with potential for extension.

Key Responsibilities:

  • Conduct thorough research and analysis to resolve claim denials, ADR requests, and certifications.
  • Develop and implement strategies to reduce denial rates and improve revenue cycle efficiency.
  • Collaborate with revenue cycle stakeholders to provide information and support related to denials and opportunities for improvement.
  • Maintain a comprehensive library of payer reference materials and stay up-to-date on industry requirements and regulations.

Requirements:

  • High School diploma or equivalent required.
  • Preferred: Certified coder or currently enrolled in a coding program.
  • Strong analytical skills, proficiency in Microsoft Windows, and emphasis on Excel.
  • Ability to prioritize and coordinate workflow, with attention to detail.
  • Knowledge of CPT, HCPC, and ICD-10 coding requirements, with emphasis on modifiers and diagnosis association.
  • Working knowledge of LCDs, NCCI, and MUE edits, as well as a general understanding of commercial, HMO, and Medicare Advantage claims, authorization, and documentation requirements.

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