Patient Denials Rep (hospital setting)

Patient Denials Rep (hospital setting) Vaco by Highspring - 3.8 Carson, CA Job Details $25 - $27 an hour 18 hours ago Benefits Health insurance Dental insurance 401(k) Vision insurance Qualifications Optimizing workflow processes Healthcare dispute resolution Appeals Contract management Medical law Insurance dispute resolution Continuous improvement Medical denial root cause analysis (RCA) Medical insurance appeals management Contract law Root cause analysis Medical billing regulations compliance Insurance claims appeal handling Full Job Description A well-known healthcare facility is looking for several Patient Denial Reps to assist with a long-term temporary project. This role can be onsite or remote in PST time zone for the right candidate. Qualified Candidates

MUST HAVE

Work and appeal commercial insurance denials in a high-volume environment Execute the full appeals lifecycle: receive, assess, document, track, respond, and resolve with third-party payers on time Identify patterns and root causes in denial trends, and document outcomes to share with management Utilize contract management systems (Oracle Splash / Epic) to identify underpaid accounts Collaborate with internal departments and external organizations to resolve disputes Maintain advanced knowledge of payer-specific billing requirements, appeal timelines, and denial codes Prepare and submit reports as required; contribute to process improvement initiatives Transition toward denial prevention strategy as the department evolves What we're looking for Minimum 5 years of patient accounting experience, specifically in denials management Strong working knowledge of commercial payer contracts, appeal timelines, and denial codes Proven track record writing successful insurance appeals Hospital-specific background strongly preferred (clinic/physician group alone is not sufficient) Oracle Splash preferred; Epic or equivalent acceptable Knowledgeable of state and federal laws related to payer contracts and the appeals process Ability to prioritize workload, meet deadlines, and resolve issues independently Education Bachelor's degree in business, healthcare, or a related field preferred — or an Associate's degree with at least 3 years of patient financial services experience. A degree is not required; 5+ years of patient accounting experience in lieu of a degree is fully acceptable. Please note — this role may not be a fit if you Have fewer than 5 years of patient accounting experience Lack denials-specific experience Come exclusively from a physician group or clinic setting with no hospital billing background Looking to hire ASAP! If this sounds like you, send you resume ASAP! NO relocation offered $25-27/hr Long term temp assignment Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual's skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company's 401(k) retirement plan.

Additional disclaimer:

Unless otherwise noted in the job description, the position Vaco/Highspring is filing for is occupied. Please note, however, that Vaco/Highspring is regularly asked to provide talent to other organizations. By submitting to this position, you are agreeing to be included in our talent pool for future hiring for similarly qualified positions. Submissions to this position are subject to the use of AI to perform preliminary candidate screenings, focused on ensuring minimum job requirements noted in the position are satisfied. Further assessment of candidates beyond this initial phase within Vaco/Highspring will be otherwise assessed by recruiters and hiring managers. Vaco/Highspring does not have knowledge of the tools used by its clients in making final hiring decisions and cannot opine on their use of AI products. Vaco by Highspring values a diverse workplace and strongly encourages women, people of color, LGBTQ+ individuals, people with disabilities, members of ethnic minorities, foreign-born residents, and veterans to apply. EEO Notice Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law. Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact . Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal. By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal. Privacy Notice Vaco by Highspring and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco by Highspring") respects your privacy and are committed to providing transparent notice of our policies. California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here. Virginia residents may access our state specific policies here. Residents of all other states may access our policies here. Canadian residents may access our policies in English here and in French here. Residents of countries governed by GDPR may access our policies here. Pay Transparency Notice Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual's skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.