Denial Specialist

Medical University of South Carolina

23h

About The Position

The denial specialist will analyze and research claim authorization denials and determine the appropriate course of action including but not limited to filing appeals and or filing adjustments. Document and monitor the status of appeal claims and follow up with payor representatives as needed to expedite resolution. Identify denial trends, root causes and make recommendations for process improvement. Ensure legal compliance by following company policies, procedures, guidelines, and as well as federal insurance regulations.

Requirements

• High School Diploma Required
• 1-3 years experience in healthcare billing and insurance follow-up.
• Experience in claim appeals and appeal follow up

Responsibilities

• Analyze and research claim authorization denials
• Determine the appropriate course of action including but not limited to filing appeals and or filing adjustments
• Document and monitor the status of appeal claims
• Follow up with payor representatives as needed to expedite resolution
• Identify denial trends and root causes
• Make recommendations for process improvement
• Ensure legal compliance by following company policies, procedures, guidelines, and as well as federal insurance regulations.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED