Denials and Eligibility Specialist
2 weeks ago
Denials and Eligibility Specialist Position Summary Revenue Cycle Denials and Eligibility Specialist will be responsible for daily QA, eligibility, frontend rejections, denial auditing, and immediate correction of all registered accounts to ensure accurate billing and reimbursement. The scope of work will encompass all Government, Commercial, and Managed Care payers, and include all service lines and all denial types. Position will be a liaison with other departments, physicians and other clinicians within and outside the organization in order to facilitate timely and accurate submission. This position will work closely with management, precertification, insurance verification, and operations to ensure trends are identified and corrected to reduce denials. Revenue Cycle Denials and Eligibility Specialist will also be involved with education and training based on identified trends and audit results. Education None Required Experience 2-3 years hospital revenue cycle experience 1-2 Years insurance experience Previous Team Lead or Supervisor Experience - Preferred License & Certification None Required Core Job Functions Directly works to resolve all eligibility denials in billing system and from payer remits within 1 business day. Directly resolves all RQA errors within 1 business day. Completes monthly Root Cause Analysis on denials and eligibility to determine trends and using the results to keep leadership informed and provide continuing education and improvement. Reviews monthly denials with leadership teams of the physician's office, ancillary departments and revenue cycle. Identifies improvement opportunities, educational needs and reduction of denials opportunities. Escalates eligibility and payer denial trends or underpayments to appropriate internal leadership for quick resolution. PIb9961fe9831e-30511-37776306
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Denials and Eligibility Specialist
1 week ago
Savannah, GA, United States St Joseph'SCandler Full timePosition SummaryRevenue Cycle Denials and Eligibility Specialist will be responsible for daily QA, eligibility, frontend rejections, denial auditing, and immediate correction of all registered accounts to ensure accurate billing and reimbursement. The scope of work will encompass all Government, Commercial, and Managed Care payers, and include all service...
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Insurance Denial Specialist
2 weeks ago
Savannah, United States St. Joseph'sCandler Full timePosition Summary The Denial Specialist will be responsible for coordinating appeals and collection efforts for denied/underpaid services performed at St. Joseph’s/Candler and its affiliates where applicable. The scope of work will encompass all Government, Commercial and Managed Care payers, and include all service lines and all denial types. Position will...
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RC Insurance Follow-up Denial Specialist I
1 week ago
Savannah, GA, United States Southeastern Orthopedic Center Full timeOptim Health is seeking a full time Insurance Follow-up/Denial Spcialist I. This is a remote position.PRIMARY CUSTOMERS, PARTNERS, AND TEAM: At Optim Health, our primary customers are patients and families. Our partners are physicians and our team members are all employees of Optim Health. GENERAL SUMMARY: Protects the financial standing of Optim Health...
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Precertification Specialist Assistant
5 days ago
Savannah, GA, United States St Joseph'SCandler Full timeOverview The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service...
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Precertification Specialist Assistant
5 days ago
Savannah, GA, United States St Joseph'SCandler Full timeOverview The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service...
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Precertification Specialist Assistant
5 days ago
Savannah, GA, United States St Joseph'SCandler Full timeOverview The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service...
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Precertification Specialist Assistant
4 days ago
Savannah, GA, United States St Joseph'SCandler Full timeOverview The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service...
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Precertification Specialist Assistant
4 days ago
Savannah, GA, United States St Joseph'SCandler Full timeOverview The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service...
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Precertification Specialist Assistant
4 days ago
Savannah, GA, United States St Joseph'SCandler Full timeOverview The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service...
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Precertification Specialist Assistant
4 days ago
Savannah, GA, United States St Joseph'SCandler Full timeOverview The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service...