Denials Specialist

CSI Companies is hiring a Denial Management Specialist for one of the most well-known and highly respected hospitals in the state of Washington.

They are recognized as one of "America's 50 Best Hospitals" and are committed to providing the highest quality of care and service, and always with absolute safety. As their team is rapidly growing, they are looking for motivated individuals to join their expanding team. 

The Denial Management Specialist is responsible for investigating health plan denials to determine appropriate action and provide resolution.

Interviewing & Accepting Applications Immediately 

Location: Kirkland, WA 98034 (on-site) 
Hours: Full-Time, Monday through Friday, 8am-5pm 
Pay: $25.00/hour - weekly pay 
Status: 6-month+ contract/consultant minimum with strong potential for extension/conversion 

Primary Responsibilities: 

• Investigates insurance denials to identify action necessary.
• Corrects claims based on denials, complaints and audits and rebills using payor approved process.
• Determines need for payor appeal and sends individualized appeal letter.  Monitors appeals for resolution.
• Adjusts denials determined to be appropriate using the corresponding adjustment code(s).
• Works the accounts that meet denial management criteria and coordinates resolution with other departments. Denial management criteria include accounts that have potential financial impact such as authorization and refer denials, bundling issues and medical necessity for all assigned payers.
• Logs all denials including actions and resolution on Denial spreadsheet.
• Identify denial pattern to identify potential process improvement.
• Produces quarterly denial reports.

Qualifications: 

• Full Vaccination for Covid-19 is required by our client* (including Boosters) 
• High School graduate or equivalent
• College degree/Vocational training in billing or business highly preferred 
• 1 year previous experience in professional billing
• Knowledge and experience in working with health care insurers' and their reimbursement systems, especially Medicare, Medicaid, Workers Compensation, Motor Vehicle and contract payers
• A good understanding of CPT, Modifiers, HCPC, ICD-10 codes and medical terminologies
• Demonstrated problem solving ability
• Ten-key by touch
• Experience working with EMR systems including EPIC or CERNER highly preferred 

About Us: 
CSI Companies is a national workforce solutions firm established in 1994 that has been awarded “Best of Staffing” for 5 years in a row. Based in Jacksonville, FL, CSI Companies provides comprehensive workforce solutions including recruiting, technology, IT consulting, and staffing for leading businesses and Fortune 500 companies, nationwide. For consideration, please submit your resume with all of your relevant experience included on it for immediate consideration. Only those candidates identified for an interview will be contacted.

Benefits Offered: 

• Weekly pay
• Medical, dental, and vision coverage
• Voluntary Life and AD&D coverage
• Paid Training
• Opportunity for advancement upon performance and availability

Apply today to become a part of the most exciting and respected healthcare staples not only in Washington state but throughout the entire nation.

CSIPROACS

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