[Hiring] Denials and Appeals Specialist @Genesis Administrative Services

Role Description

The Denials and Appeals Specialist is responsible for the follow up of denied claims from all commercial and contracted payers. The follow up includes initial assessment of the denials received to determine the appropriate process. Once determined, established policy and procedure will be followed for appeal submission.

• Reviews assigned accounts that have a payer denial based on the response from the payer and takes appropriate action, including appeals, based on the type of denial.
• Documents all necessary elements; reason for denial/audit, denial status, and action taken in the electronic medical record per denial management policy.
• Provides missing or additional information if necessary, to expedite the resolution of the denied claim. This may include writing detailed appeal letters supporting the claim and reimbursement.
• Performs all appeals and denials recovery procedures needed to appropriately and accurately resolve denied claims. This includes working with internal and external customers.
• Consistently meets productivity and quality standards established by management, recommending new approaches for enhancing performance and productivity when appropriate.
• Keeps Supervisor/Manager informed of any problems or issues related to the appeal process and/or current appeals.
• Performs other duties as assigned.

Qualifications

• High School diploma or equivalent education and experience required. College degree preferred.
• Must be proficient using MS Office or Google Suite applications.
• Strong analytical skills.
• Minimum of 1 - 2 years of previous revenue cycle management experience.

Requirements

• MUST HAVE HEALTHCARE BILLING/COLLECTIONS EXPERIENCE W/CONCENTRATION ON DENIALS / APPEALS

Benefits

• We offer Medical, Dental, and Vision plans to Full-Time team members. We offer Dental and Vision to Part-Time team members.
• Generous paid time off to Full-Time and Part-Time team members.
• Support for New Grads through the Powerback Clinical Mentorship Program starting on day one.
• Continuing Education with free CEUs through Medbridge.
• H-1B Visa & Relocation Assistance, including Visa or Green Card sponsorships.
• Exclusive discounts on Wireless/TV, Home/Auto/Renters and Pet Insurance, Childcare, Eldercare, and more.
• Earn rewards through the PowerZone Employee Recognition Program.
• Expand expertise with the Clinicians in Action professional development program.