Denials Representative

Full-Time

Admin-Clerical, Customer Service, Healthcare

Denials Representative

Remote

Louisville, TN

EXPERIENCE / SKILLS:

 One year medical billing experience
 Knowledge of physician billing policies and procedures
 Computer literate
 Ability to work in a fast-paced environment
 Excellent organizational skills
 Ability to work independently

EDUCATION:
 High school diploma or equivalent.


WORKING CONDITIONS: 

 This job will be performed in a well-lighted and well-vented environment. Requires 
constant sitting tolerance. Involves extensive computer use. 
 Set in a pleasant, high-volume, fast-paced office environment. 
 Overtime may be required and can be mandated by Management

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 task list 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

Yes

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