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Job Requirements of Denials Representative:
QUALIFICATIONS / EXPERIENCE: High school diploma or equivalent required
One-year medical billing experience preferred
Knowledge of physician billing policies and procedures
Computer literate
Ability to work in a fast-paced environment
Excellent organizational skills
Ability to work independently
SUPERVISORY RESPONSIBILITIES:
None
PHYSICAL / ENVIRONMENTAL DEMANDS:
Job performed in a well-lighted, modern office setting
Occasional standing/bending
Occasional lifting/carrying (20lbs or less)
Moderate stress
Prolonged sitting
Prolonged work on a PC/computer
Prolonged telephone work
This position may require manual dexterity and/or frequent use of the computer,
telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to
perform repetitive motions and/or meet production standards to comply with the
essential functions.
Also, may require physical and/or mental stamina to work overtime,
additional hours beyond a regular schedule and/or more than five days per week.
Overtime may be required and can be mandated by Management.
Do you meet the requirements for this job?
Denials Representative
What we Offer
- Career Growth Opportunities
- A Culture anchored in a strong sense of belonging
- Benefits (Medical/Dental/Vision) begin the first of the month following 30 days of employment
- 401k (Discretionary match)
- Generous PTO
- 8 Paid Holidays
- Equipment Provided for Remote Roles
JOB DESCRIPTION OVERVIEW:
This position is responsible for reviewing various carrier denials at their assigned Billing Group. Maintains accuracy and production to ensure invoices are being processed efficiently.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Reviews ETM tasklist assignment, comments, and rebills claim as necessary
Reviews denials to determine appropriate action based on carrier requirements
Assembles and forwards appropriate documentation to the senior representative for carrier related issues
Reviews carrier provider manuals for billing updates as needed
Reports any consistent errors found during review that affect claims from being processed correctly
Participates in department meetings with Accounts Receivable Team
Turns to Senior/Supervisor for unusual circumstances that may include write-offs, fee schedules, claims, etc.
Performs any and all duties as directed by Senior Representative, Supervisor, and Accounts Receivable Manager
Complete charge corrections and adjustments as requested
Job Requirements:
High school diploma or equivalent required
One-year medical billing experience preferred
Knowledge of physician billing policies and procedures
Computer literate
Ability to work in a fast-paced environment
Excellent organizational skills
Ability to work independently
SUPERVISORY RESPONSIBILITIES:
None
PHYSICAL / ENVIRONMENTAL DEMANDS:
Job performed in a well-lighted, modern office setting
Occasional standing/bending
Occasional lifting/carrying (20lbs or less)
Moderate stress
Prolonged sitting
Prolonged work on a PC/computer
Prolonged telephone work
This position may require manual dexterity and/or frequent use of the computer,
telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to
perform repetitive motions and/or meet production standards to comply with the
essential functions.
Also, may require physical and/or mental stamina to work overtime,
additional hours beyond a regular schedule and/or more than five days per week.
Overtime may be required and can be mandated by Management.