Children's Hospital Of The King's Daughters
Denial Resolution Specialist
Children's Hospital Of The King's Daughters, Chesapeake, Virginia, United States, 23322
GENERAL SUMMARYThe Denial Resolution Specialist is responsible for all activities related to resolving, monitoring and appealing claim denials from third party payers. Responsible for accurate data collection, documentation, and data retrieval with computerized systems. Uses critical analytical skills to effectively resolve claim denial issues. Reports to department leadership.
ESSENTIAL DUTIES AND RESPONSIBILITIESAnalyzes and prepares payer appeals for denied claims.Ensures accuracy of payment received.Addresses discrepancies in payments in a timely manner.Prepares adjustment requests to resolve account balances.Performs other duties as assigned.
LICENSES AND/OR CERTIFICATIONSNone required.
MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTSHigh school diploma or equivalent.Three to five years' experience in a hospital patient account department, physician office or medical services organization required.Must be familiar with third party payer insurance verification, billing processes, medical terminology, ICD-9, CPT and HCPC coding.Certification in medical office billing a plus.Proficiency in computer keyboarding skills required.Ability to relate well with the public.Ability to effectively gather and exchange information in both oral and written communications with proper grammar, spelling and punctuation.
WORKING CONDITIONSNormal office environment with little exposure to excessive noise, dust, temperature and the like.
PHYSICAL REQUIREMENTSClick here to view physical requirements.
ESSENTIAL DUTIES AND RESPONSIBILITIESAnalyzes and prepares payer appeals for denied claims.Ensures accuracy of payment received.Addresses discrepancies in payments in a timely manner.Prepares adjustment requests to resolve account balances.Performs other duties as assigned.
LICENSES AND/OR CERTIFICATIONSNone required.
MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTSHigh school diploma or equivalent.Three to five years' experience in a hospital patient account department, physician office or medical services organization required.Must be familiar with third party payer insurance verification, billing processes, medical terminology, ICD-9, CPT and HCPC coding.Certification in medical office billing a plus.Proficiency in computer keyboarding skills required.Ability to relate well with the public.Ability to effectively gather and exchange information in both oral and written communications with proper grammar, spelling and punctuation.
WORKING CONDITIONSNormal office environment with little exposure to excessive noise, dust, temperature and the like.
PHYSICAL REQUIREMENTSClick here to view physical requirements.