Denials - Executive/Senior Executive

Role & responsibilities

• Denial Identification and Analysis: Identify, categorize, and analyze denials and underpayments from Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs).
  
• Claim Resubmission and Appeals: Correct and resubmit denied claims, or prepare and submit appeals following payer guidelines and timelines.
  
• Payer Communication: Communicate with insurance companies to resolve issues leading to denials and ensure accurate reimbursement.
  
• Preventative Action: Review denial trends and work with other RCM teams to implement processes that can prevent future denials.
  
• Team Collaboration: Collaborate with coding, billing, and patient financial services teams to address denial issues.
  
• Regulatory Compliance: Stay updated with the latest billing and coding regulations, insurance policies, and industry trends.

Preferred candidate profile

• Prior experience in denials management, healthcare billing, or a related role.
  
• Strong understanding of medical billing processes, coding, and payer requirements.
  
• Excellent problem-solving and negotiation skills.
  
• Detail-oriented with strong analytical skills.
  
• Excellent communication skills, both written and verbal.
  
• Proficiency in using healthcare billing software and Microsoft Office Suite.

Perks and benefits

In house meals and cab provision