Denial Management Specialist

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.