Patient Accounting Denials Specialist I

About the role

Build your Career. Make a Difference. Presbyterian is hiring a skilled Patient Accounting Denials Specialist I. Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A/R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activities. Type of Opportunity: Full time Job Exempt: No Job is based: Remote Workers New Mexico Work Shift: Weekday Schedule Monday-Friday (United States of America)

Responsibilities

• Performs denial follow-up activities for assigned payors utilizing work queues.
• Submits corrected claims , reconsiderations and/or appeals to overturn denials .
• Responsible for providing any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials.
• Must follow process/procedures to ensure timely follow up on outstanding denials.
• Document accounts in accordance with established PHS policies/procedures.
• Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.)
• Must utilize communication skills to be an effective team member.
• Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns.
• Must develop and maintain professional work relationships with team members, PHS departments and outside agencies.

Requirements

• High school degree or GED required, short-term training on insurance collections and claims processing. Minimum two years experience in insurance follow-up, billing, and collections. Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.
• Must be passionate about being part of an organization focused on continuously improving patient experiences and the health of our community.
• Must have a strong work ethic and demonstrated ability to work effectively in a team environment.
• Must be able to prioritize and manage a high-volume workload and be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.
• All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
• Wellness
• Why work at Presbyterian?
• As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
• About Presbyterian Healthcare Services
• Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
• AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
• We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

Benefits

Additional Information

Location Address: Remote Office Santa Fe, NM 87501 Compensation Pay Range: Minimum Offer $15.87 Maximum Offer $23.04 Now Hiring: Patient Accounting Denials Specialist I

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