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Denial Reimburse Specialist
| Company | Franciscan Health |
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| Location | Indiana, USA |
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| Salary | $15.5 – $21.88 |
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| Type | Full-Time |
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| Degrees | |
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| Experience Level | Junior, Mid Level |
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Requirements
- High School Diploma/GED
- 2 years Revenue Cycle Required
Responsibilities
- Conduct inquiries via phone, mail, fax, or electronically to conduct follow-up on the accounts that have not been denied and resubmitted for payment.
- Conduct follow-up with insurance carriers, physicians, and other stakeholders that can validate and assist with actions and information needed in order to properly review, dispute or appeal denial until a determination is made to conclude the appeal.
- Resubmit upheld denials as warranted and monitor resubmissions for payment; resubmit claims using the denial program re-bill requests feature, ensuring all modifications to the account are reflected on the claim form.
- Ensure information sent to insurance carriers have all release of information necessary and is HIPPA compliant.
- Analyze reports and use software to track, trend and identify root causes of denials; offer suggestions for process improvement to resolve denial issues, supported by documentation and data.
- Review denials and payment discrepancies identified through the denial system, which are directly related to the verification, authorization and registration process.
- Prepare and submit patient record requests from care delivery sites and provide correspondence to patient on requested information.
Preferred Qualifications
- Preferred Associate’s degree
