UMass Memorial Health
Denial Resolution Specialist I
UMass Memorial Health, Worcester, Massachusetts, us, 01609
Exemption Status:
Non-Exempt
Schedule Details:
Monday through Friday
Scheduled Hours:
8a-4:30p
Shift:
1 - Day Shift, 8 Hours (United States of America)
Hours:
40
Cost Center:
99940 - 5404 Denials
Union:
SHARE (State Healthcare and Research Employees)
This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.
Major Responsibilities:
Completes appropriate actions needed for an effective appeal including conducting authorization research, rebilling, and balance write off or transfer to next responsible party. Escalates issues as appropriate.
Corresponds with third party payers, hospital departments, and patients to obtain information required for denial resolution following payer timelines. Releases information following Federal, State and Hospital guidelines.
Uses assigned work queues and prioritization standards and guidelines to perform denial resolution follow up.
Uses reference material to troubleshoot payer issues and increase understanding of denial resolution techniques. Reference payer websites as needed.
Analyzes and researches the denial reasons for each assigned denial code.
Position Qualifications:
License/Certification/Education:
Required:
High School diploma
Experience/Skills:
Required:
Previous Revenue Cycle knowledge in one of the following areas including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party Reimbursement.
Ability to perform assigned tasks efficiently and in a timely manner.
Ability to work collaboratively and effectively with people.
Exceptional communication and interpersonal skills.
Preferred:
One or more years of experience in health care billing functions.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.
As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.
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Non-Exempt
Schedule Details:
Monday through Friday
Scheduled Hours:
8a-4:30p
Shift:
1 - Day Shift, 8 Hours (United States of America)
Hours:
40
Cost Center:
99940 - 5404 Denials
Union:
SHARE (State Healthcare and Research Employees)
This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.
Major Responsibilities:
Completes appropriate actions needed for an effective appeal including conducting authorization research, rebilling, and balance write off or transfer to next responsible party. Escalates issues as appropriate.
Corresponds with third party payers, hospital departments, and patients to obtain information required for denial resolution following payer timelines. Releases information following Federal, State and Hospital guidelines.
Uses assigned work queues and prioritization standards and guidelines to perform denial resolution follow up.
Uses reference material to troubleshoot payer issues and increase understanding of denial resolution techniques. Reference payer websites as needed.
Analyzes and researches the denial reasons for each assigned denial code.
Position Qualifications:
License/Certification/Education:
Required:
High School diploma
Experience/Skills:
Required:
Previous Revenue Cycle knowledge in one of the following areas including PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding and/or 3rd party Reimbursement.
Ability to perform assigned tasks efficiently and in a timely manner.
Ability to work collaboratively and effectively with people.
Exceptional communication and interpersonal skills.
Preferred:
One or more years of experience in health care billing functions.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.
As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.
#J-18808-Ljbffr