[Hiring] Patient Accounting Denials Specialist I @Presbyterian Healthcare Services

Role Description

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: Days (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.
• Maintains strictest confidentiality, adheres to all HIPAA and CMS compliance rules and regulations.
• Perform other duties as assigned by the Denial Supervisor and/or Manager.

Qualifications

• 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.
• Experience with Microsoft Office Suite products preferred.
• Excellent organizational, problem-solving, verbal, and written communication skills, along with attention to detail and the ability to interact effectively with other functional areas and management teams are required.
• Must have a strong work ethic and demonstrated ability to work effectively in a team environment.

Benefits

• Comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
• Employee Wellness rewards program designed to provide engaging opportunities to enhance health and activate well-being.
• Earn gift cards and more by participating in wellness activities like wellness challenges, webinars, preventive screenings, and more.