Denials Management Specialist Company:

Southwoods Health Location:

Boardman, Ohio Schedule:

Full-time. Monday-Friday 8am-4:30pm. About the

Role:

Southwoods Health is hiring a Denials Management Specialist . In this role, you will be responsible for corresponding with insurance carriers regarding aged, unpaid claims. The ideal candidate will work diligently to secure and expedite payments through proactive follow-up and the strategic appeals resolution process.

Essential Duties:

Worklist Management:

Review tasks, credit balances, and denial worklists on a daily and weekly basis.

Payer Correspondence:

Contact insurance companies directly to determine the status of unpaid or denied accounts, and navigate online insurance websites efficiently.

Documentation & Appeals:

Prepare, file, and submit formal insurance appeals. Send necessary copies or supporting clinical documentation required by insurance carriers.

Account Logging:

Detailed note-taking of all contact interactions with insurance companies and patients within the patient's account records.

Claims & Resolutions:

Mail insurance claim forms with required attachments, investigate insurance credit balances for resolution, and identify/report billing errors to the supervisor for policy corrections.

Industry Compliance:

Review insurance newsletters and websites regularly for policy updates. Ensure all processes maintain strict compliance with regulatory agencies (OSHA, ODH, BOP, TJC, etc.). What You'll Need (Qualifications):

Education/Training:

Completed training or courses in business office operations, computer applications, and medical terminology.

Certification:

Collection or billing certification is highly preferred.

Core Knowledge:

Comprehensive knowledge of operational aspects of the revenue cycle and proven measures to take in successfully resolving complex claim issues.

Key Skills:

Effective communication skills, professional problem-solving capabilities, and the ability to maintain a professional demeanor at all times backed by strong ethical principles. Why Choose Southwoods? At Southwoods, it's not just about the treatment, but how you're treated. Join our award-winning team today.

Apply online:

www.southwoodshealth.com #SWH