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Denials Reimbursement Specialist

2 months ago


Hammond, Indiana, United States Franciscan Health Full time

About Franciscan Health

Franciscan Health is a leading healthcare provider in the Midwest, serving patients across Indiana and Illinois through its 12 ministries and access points.

Job Summary

We are seeking a highly skilled Denials Reimbursement Specialist to join our team. As a key member of our Revenue Cycle team, you will be responsible for coordinating business office operations and ensuring timely and accurate reimbursement for patient services.

Key Responsibilities

  • Conduct thorough investigations into denied claims, collaborating with insurance carriers, physicians, and other stakeholders to resolve issues and secure payment.
  • Resubmit overturned denials and monitor denial resubmissions for payment, utilizing our denial program re-bill requests feature to ensure accurate and timely reimbursement.
  • Analyze reports and utilize software to track, trend, and identify root causes of denials, providing data-driven recommendations for process improvement.
  • Review denials and payment discrepancies related to verification, authorization, and registration processes, ensuring compliance with HIPAA regulations.
  • Prepare and submit patient record requests from care delivery sites and provide correspondence to patients regarding requested information.

Requirements

  • High School diploma required
  • 2 years of Revenue Cycle experience required

Work Environment

This is a hybrid role, requiring both on-site and remote work. A flexible schedule (7-5pm) with an 8-hour shift is available.

Equal Opportunity Employer

Franciscan Health is an equal opportunity employer, committed to providing a work environment free from discrimination and harassment. We reserve the right to object to local, state, or federal ordinances that violate our values and the free exercise of our religious rights.