PB-Denials & Appeals Specialist, FT, Days Position Available In Richland, South Carolina
Tallo's Job Summary: The PB-Denials & Appeals Specialist position at Prisma Health in Columbia, SC is a full-time role with an estimated salary of $28.8K - $42.6K a year. The job involves analyzing trends specific to denials, root cause, and accounts receivable impact, submitting claims, contacting payers, and initiating the appeal process. Requirements include a high school diploma or equivalent and two years of billing, bookkeeping, or accounting experience.
Job Description
PB-Denials & Appeals Specialist, FT, Days Prisma Health – 3.5
Columbia, SC Job Details Full-time Estimated:
$28.8K – $42.6K a year 1 day ago Qualifications Mid-level High school diploma or GED Accounting Bookkeeping 2 years Full Job Description Inspire health. Serve with compassion. Be the difference. Job Summary Analyzes and articulates trends specific to denials, root cause, and accounts receivable impact. This is a remote position Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health’s values: Inspire health. Serve with compassion. Be the difference. Analyzes and articulates trends specific to denials, root cause, and A/R impact Completes and submits claims via electronic or paper claim submission according to governmental regulations, agency policies, Prisma Health guidelines and timeliness standards Contacts payer and makes hard inquiries on account status. Escalates problem account and initiates the appeal process. Documents billing activity on the patient accounts according to departmental guidelines; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to departmental leaders. Properly documents accounts clearly with indicators and activities so that tracking and trending can be prepared for further analysis Adheres to policies and procedures as required by Prisma Health and follows all compliant regulatory payer guidance. Ensures all work is compliant with privacy, HIPAA, and regulatory requirements Knowledgeable of the job functions required for a Credit Processing Specialist, Payment Research Specialist, and a Quality Assurance Specialist. Should be cross trained and proficient operate in any of these roles if the need arises. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education – High School diploma or equivalent OR post-high school diploma/highest degree earned Experience – Two (2) years billing, bookkeeping, accounting experience In Lieu Of NA Required Certifications, Registrations, Licenses NA Knowledge, Skills and Abilities Knowledgeable of the job functions required for a Credit Processing Specialist, Payment Research Specialist, and a Quality Assurance Specialist. Work Shift Day (United States of America) Location Corporate Facility 7001 Corporate Department 70019231 PBO Radiology A/R Team Share your talent with us!
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to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
