DME Denials/Appeals Specialist x3

3 weeks ago

Hollywood, United States Prestige Staffing - Healthcare Jobs - Revenue Cycle Full time
Job DescriptionJob DescriptionJobID: 48012

Prestige Staffing has been tasked by one of our best clients to find Medical Insurance Denials/Appeals Representative to interview and go to work ASAP Candidate must be hard working and a self-starter. If you want the opportunity to work in a rewarding and dynamic environment, this is your chance. This is a temp to perm position.

Pay: $18-20/hr

Location: Onsite, Miramar, FL

JOB RESPONSIBILTIES:

  • Identify, review and resolve denials manually and/or electronically by using the designated information technology on a timely basis. Reviews EOBs and remittance reports for denials, errors and resubmits claims with correct data
  • Confirm denial reasons.
  • Generate an appeal based on the dispute reason and contract terms specific to the payors
  • Follow specific payor guidelines and medical policies for appeal submissions
  • Escalate exhausted appeal efforts to the appropriate parties 
  • Research and analyze denial data and coordinate denial recovery responsibilities
  • Review patient medical records and utilize regulatory and payor knowledge to Identify, analyze, and research frequent root causes of denials and develops corrective action plans for resolution
  • Document all account activity on each account through descriptive account notes in employer’s system
  • Request documentation from clients as required to resolve accounts
  • Adhere to all policies and procedures

QUALIFICATIONS:

  • High School Diploma.
  • Three (3) years job related experience in Business Office or Central Business Office (CBO).
  • Working experience with medical terminology and claim denials / underpayments
  • Proficiency in Microsoft Office products (e.g. Word and Excel)
  • Demonstrates understanding of medical terminology
  • Knowledge of CPT, HCPCS, ICD-10 coding procedures
  • Good communications skills, both written and oral
  • Knowledge of medical billing and collection practices
  • In-depth working knowledge of Commercial, Managed Care and Government insurance carriers
#zr-rep

  • Clinical Claims Processor

    4 days ago

    Hollywood, Florida, United States Empire Imaging Inc Full time

    Job Title: Clinical Claims ProcessorEstimated Salary: $60,000 - $70,000 per yearEmpire Imaging Inc. is hiring a skilled Clinical Claims Processor to oversee the entire claims lifecycle, from initial submission to final payment. As a key member of our team, you will work closely with healthcare providers and clients to ensure seamless claims processing.Key...

  • Medical Service Specialist

    2 days ago

    Hollywood, Florida, United States ZOLL LifeVest Full time

    Job Title: Medical Service SpecialistThe Cardiac Management Solutions division of ZOLL Medical Corporation is seeking a skilled Medical Service Specialist to provide critical support to patients in need. As a representative of our LifeVest technology, you will be responsible for training patients and caregivers on the use and care of this lifesaving...

  • Painter and Decorator Specialist

    2 weeks ago

    Hollywood, Florida, United States Margaritaville Hollywood Beach Full time

    Painter and Decorator Specialist RoleMargaritaville Hollywood Beach Resort is seeking a talented Painter and Decorator Specialist to bring color and life to our beautiful spaces. This exciting opportunity allows you to work on a variety of projects, from interior and exterior painting to touch-ups and renovations.We require a dedicated and enthusiastic...

  • Pre-Service Coordinator Specialist

    4 weeks ago

    Hollywood, Florida, United States OneHome Full time

    Job SummaryBecome a part of our team and help us put health first. As a Pre-Service Coordinator, you will play a crucial role in all aspects of referral management, ensuring accurate processing of incoming requests for homecare, DME/supplies, and pharmacy/infusion services. You will work closely with healthcare providers and patients to provide exceptional...

  • Healthcare Operations Specialist

    4 weeks ago

    Hollywood, Florida, United States Community Care Plan Full time

    Job DescriptionWe are seeking a skilled Healthcare Operations Specialist to join our team at Community Care Plan. This role will be based in Broward County, Florida.Key Responsibilities:Manage provider contracts and negotiate agreements to ensure successful collaboration between providers and the organization.Develop and implement education programs to...

  • Culinary Specialist

    4 weeks ago

    Hollywood, Florida, United States El Nuevo Juana Cafe Inc Full time

    El Nuevo Juana Cafe Inc. is Seeking a Talented Culinary SpecialistWe are committed to serving our customers with high-quality meals prepared by skilled culinary experts like you.Job SummaryAs a Line Cook at El Nuevo Juana Cafe Inc., you will be responsible for preparing delicious meals using fresh ingredients and presenting dishes in an appealing manner. If...

  • Food and Consumables Team Associate

    4 weeks ago

    Hollywood, Florida, United States Walmart Full time

    At Walmart, we are seeking a highly motivated and detail-oriented Food and Consumables Team Associate to join our team. This role is ideal for individuals who enjoy working in a fast-paced environment and take pride in providing exceptional customer service.About the RoleThe successful candidate will be responsible for moving incoming merchandise out to the...

  • Construction Code Enforcement Specialist

    3 days ago

    Hollywood, Florida, United States Vets Hired Full time

    Required Skills and QualificationsHigh School Diploma or GED equivalentValid State of Florida Driver's LicenseCertification as an Structural Plans Examiner and as an Structural Inspector from the State of Florida BCAIBBoard of Rules and Appeals certification and at least one of the following qualifications:Florida Registered Architect or Licensed...

  • Pickle Creations Specialist

    4 weeks ago

    West Hollywood, United States Kaylin and Kaylin Pickles Full time

    Company OverviewKaylin and Kaylin Pickles is a revolutionary fast casual dining experience dedicated to customizable pickles with a wide range of toppings. Our team is looking for motivated individuals to join us in making this groundbreaking concept a success.SalaryWe offer a competitive salary, estimated at around $40,000 per year, depending on experience...

  • Visual Merchandising Specialist | Melrose

    6 days ago

    West Hollywood, United States Disability Solutions Full time

    Description & RequirementsWho We Arelululemon is an innovative performance apparel company for yoga, running, training, and other athletic pursuits. Setting the bar in technical fabrics and functional design, we create transformational products and experiences that support people in moving, growing, connecting, and being well. We owe our success to our...