General Information:
Job title: Denial Management Specialist
Schedule: Full-time, 80 hours per pay period; Monday-Friday, 8:00am - 4:30pm
Weekend rotation: No weekends
Holiday rotation: Paid Holidays
Position Summary:
The Denial Management Specialist position gathers, interprets, and reviews data to assess for root cause analytics to then implement process improvement to reduce denials and write offs to optimize A/R.
Position Responsibilities:
- Creates Revenue Cycle reports
- Responsible for collecting, researching and analyzing business and operational data.
- Provides monitoring and trending of system denials.
- Works with other departments, including operational, to reduce the dollar amounts of denials and rework.
- Works denials to resolution.
- Collaborates with other revenue cycle departments to educate on denial trends.
- Identifies and monitors process improvement efforts with the revenue cycle.
- Establishes definitions and criteria for reporting avoidable denials.
- Attends workshops and seminars to maintain a high level of knowledge and capabilities related to position.
- Perform other duties as requested.
Position Requirements:
- High school diploma or equivalent required.
- AA or 4 years of equivalent experience required.
- 5+ years of related work experience preferred.
- Experience working in the medical industry preferred.
- Exceptional accuracy and attention to detail required.
Knowledge, Skills, & Abilities
- Intermediate to Expert proficiency with computers is required.
- Thorough understanding of billing process.
- Basic understanding of coding.
- Strong quantitative and analytical competency.
- Self-starter with excellent interpersonal communication and problem-solving skills.