Denials Management Specialist
2 months ago
At Methodist Health System, we are seeking a highly skilled Denials Management Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for reviewing and resolving denials for commercial and government payers, as well as physician and facility claims.
Key Responsibilities- Analyze denials and ensure compliance with payer contracts and CMS regulations.
- Research and resolve contractual and reimbursement issues, providing accurate and timely information to internal and external stakeholders.
- Assist staff with work volume as needed, providing contract and payer recommendations.
- Participate in payer meetings and escalate payer issues as necessary.
- Provide training on contracts and reimbursement to other areas as needed.
- High School Diploma or General Educational Development (G.E.D.) required.
- College coursework in accounting and/or healthcare preferred.
- Minimum 1-2 years experience working for a third-party payer or healthcare provider required.
- Minimum 1 year of insurance billing experience preferred.
- Six months Institutional and Professional ICD and CPT coding preferred.
- Six months experience with DRG reimbursement and outpatient, including ASC grouper, ER, and outpatient reimbursement preferred.
- Experience in researching Institutional and Professional claims to determine correct contract reimbursement using payer contracts preferred.
- Strong analytical and problem-solving skills.
- Excellent communication and interpersonal skills.
- Ability to maintain confidentiality and handle sensitive information.
- Knowledge of medical terminology and coding systems.
- Proficiency in Microsoft Office, including Word, Excel, and Outlook.
- Ability to learn new software programs and adapt to changing technology.
Methodist Health System is a comprehensive healthcare organization dedicated to providing exceptional care to our communities. We are committed to delivering high-quality, patient-centered care and are seeking talented individuals to join our team.
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Denials Management Specialist
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Magstatt-le-Bas, Grand Est, United States Methodist Health System Full timeAbout the RoleWe are seeking a highly skilled and detail-oriented Denials Management Specialist to join our team at Methodist Health System. As a key member of our revenue cycle team, you will be responsible for reviewing and resolving denials for commercial and government payers, as well as physician and facility claims.Key ResponsibilitiesDenial Review and...
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Magstatt-le-Bas, Grand Est, United States Methodist Health System Full timeJob SummaryNebraska Methodist Health System is seeking a highly skilled Denials Management Analyst to join our team. As a key member of our revenue cycle team, you will be responsible for reviewing denials, analyzing contractual and reimbursement issues, and escalating appeals to payers as needed.ResponsibilitiesAnalyze denials and ensure accuracy of...
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Magstatt-le-Bas, Grand Est, United States Methodist Health System Full timeJob SummaryNebraska Methodist Health System is seeking a highly skilled Denials Management Analyst to join our team. As a key member of our revenue cycle team, you will be responsible for reviewing denials, analyzing contractual and reimbursement issues, and escalating appeals to payers as needed.ResponsibilitiesAnalyze denials and ensure accuracy of...
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Magstatt-le-Bas, Grand Est, United States Methodist Health System Full timeJob SummaryNebraska Methodist Health System is seeking a highly skilled Denials Management Analyst to join our team. As a key member of our revenue cycle team, you will be responsible for reviewing denials, analyzing contractual and reimbursement issues, and escalating appeals to payers as needed to obtain maximum reimbursement in compliance with payer...
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