denial prevention specialist.weatherford, texas (remote)posted 5 days ago job detailssummary$23.63 - $23.64 per hourtemporaryhigh schoolcategoryoffice and administrative support occupations reference AB_5064669 job details In this role, you will be the key to resolving complex claim denials and maximizing collections. You will utilize your deep knowledge of Medicare, Medicaid, and commercial payors to research, review, and successfully appeal unpaid claims. You will enjoy the comfort and flexibility of a work-from-home setup while staying connected with your team through occasional in-office meetings, training, and events in the DFW area. If you possess a "one-call resolution" mindset, thrive in a fast-paced environment, and are ready to bring your physician billing expertise to a growing team, this is the perfect opportunity for you. Responsibilities Analyze payer denials utilizing denial groupers and actively prepare and submit successful appeals. Review Explanations of Benefits (EOB) to determine claim management and contact insurance carriers to check status, verify insurance, and resolve underpaid claims. Communicate effectively with patients and third-party payers to resolve outstanding insurance balances. Process necessary account adjustments as required by specific plan reimbursement guidelines. Serve as a knowledgeable, professional liaison between clinical departments and the management team.

Qualifications & Skills Experience:

2+ years of recent experience in medical claims recovery and/or collections required. Must have hands-on experience in Physician Billing and actively processing appeals.

Education:

High School Diploma required; Associate's Degree preferred.

Industry Knowledge:

understanding of Managed Care, Commercial, Medicare, and Medicaid billing regulations. Familiarity with CMS 1500, ICD-9, and CPT coding is highly preferred.

Communication:

Must be able to read, write, and speak English fluently with excellent customer service and interpersonal skills.

Technical Skills:

Quick and accurate alpha/numeric data entry skills.

Work Style:

Self-starter capable of handling a large volume of work independently in a fast-paced, production-oriented environment.

salary:

$23.63 - $23.64 per hourshift: Firstwork hours: 7:30 AM - 4

PMeducation:

High SchoolResponsibilitiesAnalyze payer denials utilizing denial groupers and actively prepare and submit successful appeals. Review Explanations of Benefits (EOB) to determine claim management and contact insurance carriers to check status, verify insurance, and resolve underpaid claims. Communicate effectively with patients and third-party payers to resolve outstanding insurance balances. Process necessary account adjustments as required by specific plan reimbursement guidelines. Serve as a knowledgeable, professional liaison between clinical departments and the management team.

SkillsExplanation of Benefitsclaims, appealsManaged CareQualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer:

Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.