Denials Representative

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

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