Denial Management Specialist

Adecco is currently assisting a local client in their search to fill an exciting Denial Management Specialist role in Louisville, KY!  Apply now if you meet the qualifications listed below!

Responsibilities, Qualifications, & Details:

  • Reviews and researches claim in which a denial payment has been received from the payer in a timely manner.
  • Manages and Develops necessary department and executive level reporting
  • Identifies the root cause of the denial and addresses the denial issue with the appropriate department (i.e. Billing, CDM, Clinical Documentation, Coding, etc.)
  • Utilizes all appreciate systems to effectively research claims and complete steps to submit information necessary to process or appeal claims
  • Investigates and ensures that questions and requests for information are responded to in a timely and professional manner to ensure resolution of outstanding claims
  • Completes and requests adjustments to a claim, as appropriate, based on the dollar threshold of the adjustment
  • Reviews, works and reports all claims that have aged more than the specified grace period stipulated in policies and / or contacts
  • Organizes work/ resources to accomplish objectives and meet deadlines
  • Demonstrates problem- solving skills related to denial analysis
  • Demonstrates the willingness and ability to work collaboratively with other key internal and external staff, both clinically and administratively to obtain necessary information to address denial management issues
  • Meets productivity requirements to ensure excellent service is provided to customers
  • Maintains compliance with established corporate and departmental policies and procedures
  • Maintains stable performance under pressure and handles stress in ways to maintain relationships with patients, customers and co-workers
  • Identify all denial trends and provide education of steps to prevent future avoidable denials.
  • Initiate/Manage all appeals in a timely manner.
  • Organize the work flow to ensure that denials are worked according to timely filing deadlines and conditions of payment.
  • Communicate all denial trends and denial increases to direct supervisor to positively affect the volume of denials.
  • Building relationships with payors.
  • Complete special projects as assigned by Supervisor/Manager.

Position Requirements

  • High School Diploma required; Bachelor’s Degree preferred
  • At least 3-5 years of experience in revenue cycle and/or billing experience
  • Denial Management and/or electronic billing experience are preferred
  • Highly motivated individual with attention to detail in fast paced environment
  • Good internal/external customer communication skills required
  • Able to work independently and collaboratively as a team player
  • Systems include Excel, Power Point, Zirmed billing system

How to Apply: Click on “Apply Now” to be considered for this position or any other opportunities with Adecco.

IMPORTANT: This position is being recruited for by Adecco’s National Recruitment Center, not your local Adecco Branch Office. To be considered for this position, you must use the “apply now” button to submit your resume. If you have questions about the position, you may contact the recruiter recruiting for this position listed above. For other opportunities, available at Adecco go to www.adeccousa.com.

If you have any questions surrounding the application process, please feel free to reach out to: Rushaun.Carter@adeccona.com

The Adecco Group is a global leader in HR services.  Our group connects over 700,000 associates with our business clients each day through our 6,600 offices in over 70 countries and territories around the world.  We offer employment opportunities at any stage in your professional career.  Contact us today to discuss available contract and direct hire positions.  Adecco Group provides one of the most comprehensive benefits packages in the industry to contract workers to include Holiday, 401(k), Insurance Benefit Plans

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Reference number US_EN_99_022862_458109