Medical Billing Specialist - Denials and Appeals
Job Title: Medical Billing Specialist with focus on Denials and Appeals
Children’s Respiratory and Critical Care Specialists, P.A. provides families with outpatient specialty care for respiratory illness and inpatient services for children with complex multi-system illness and trauma.
Provide daily management of claims processing and denied claims. Perform regular and consistent follow up, denial management, correction and/or reprocessing claims as necessary to ensure timely resolution.
- Manage all denials and accounts receivables daily
- Contact payers to determine reason for claim denial
- Provide a high level of customer service to families and third party payers
- Perform charge corrections, submit replacement appeals to third party payers
- Utilize all resources available, including electronic inquires to verify eligibility, and claim status
- Exercise good judgement towards account resolution and document all activity in clear, accurate, and consistent manner
- Meet departmental productivity and quality assurance standards
- Resolve billing errors and work with third party payers, toward efficient and effective claims resolution
- Inform business office manager of repetitive billing errors, third party payer trends, denials, or payment fluctuation, to ensure proper handling and escalation when necessary
- Maintain a thorough knowledge of third party billing and collection requirements for payers
- Contact families for additional information in order to have claims processed and paid in a timely manner
- Actively participate in creating and implementing improvements
- Performs other responsibilities as needed/assigned
*This job description is not intended to be all-inclusive, but is intended to be a generalized guide of job duties. Management may change the job responsibilities and expectations based on business requirements.
Job Type: Full-time
Monday – Friday from 8 am to 4 pm in our Minneapolis location
Desired start date: July 2019
- Experience in medical claims/denials: 2 years (Required)
- eClinicalWorks experience (Preferred but not required)
- Experience with Microsoft Office (Word, Excel, Outlook)
Interested applicants should submit cover letter and resume to firstname.lastname@example.org.