Description

We are seeking a detail-oriented and experienced Denials Specialist to join our financial team. The ideal candidate will be tasked with managing and resolving insurance denials in a timely and effective manner. This individual will work diligently to identify root causes of denials, take actionable steps for denial resolution, resolve payer disputes, and consistently follow up on claims.

Job Responsibilities:

1. Manage and resolve instances of insurance denials, working alongside other teams when necessary.

2. Identify root causes of denials and take appropriate actions to resolve them swiftly and effectively.

3. Timely appeals submission for denials resolution, ensuring that all necessary information is accurate and comprehensive.

4. Resolve payer disputes, employing assertive but fair negotiation tactics.

5. Follow up on claims with insurance companies to ensure proper resolution.

6. Utilize online portals to assess denials and explanations of benefits, employing deep knowledge and understanding of the portals' functionality.

7. Identify potential trends among denials occurring in the same category.

8. Review Explanation of Benefits (EOB), ensuring the correct fee is applied, understand what they're seeing, and know where to look on EOB.

9. Liaise with payers to discuss agreements and negotiate on disputed claims.

10. Participate in ongoing training sessions to stay up-to-date with industry practices.

Requirements

Qualifications:

1. Minimum of 3 years' experience in revenue cycle management.

2. Strong understanding of insurance denials and the associated resolution processes.

3. Excellent verbal and written communication skills.

4. Proficient in using online portals to access denials and explanations of benefits.

5. Able to juggle multiple tasks and priorities effectively.

6. Proven problem-solving abilities.

7. Able to work independently and within a team structure.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

© 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use.

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