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    Denial Management Specialist - Louisville, United States - Commonwealth Pain and Spine

    Commonwealth Pain and Spine
    Commonwealth Pain and Spine Louisville, United States

    3 days ago

    Default job background
    Description

    Commonwealth Pain and Spine (CP&S) is one of the fastest growing, progressive, comprehensive pain management groups in Kentucky and Southern Indiana. Our team of friendly physicians are all board certified in pain medicine and anesthesiology and take the time to educate our staff. Our facilities are brand new with the latest technology. We have a team/family-oriented culture with great hours, competitive pay, benefits, and open interaction between our staff and management.

    The Denial Management Associate researches and analyzes denial data and coordinates denial recovery responsibilities.

    Job Duties & Responsibilities:

    • Researches and analyzes denial data and coordinates denial recovery responsibilities and report findings to leadership
    • Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of denial
    • Develops reporting tools that effectively measure and monitor processes throughout the denials management process in order to support process improvement
    • Prioritizes activities to work overturns in a timely manner to alleviate untimely filings
    • Uses reports that categorize denials to assign tasks or personally work to overturn denials
    • Identifies and pursues opportunities for improvements in denial performance
    • Processes work lists to facilitate prompt intervention of insurance denials
    • Researches, responds, and documents insurer and patient correspondence/inquiry notes regarding coding coverage, benefits, and reimbursement on patient accounts
    • Research rejections included in EOBs for resolution and files appropriately
    • Makes management aware of any issues or changes in the billing system, insurance carriers, and/or networks
    • All other duties assigned including duties performed for affiliates, assigns, lessees, contractors or other third parties
    Requirements

    Skills & Abilities:
    • Exceptional communication and interpersonal skills to interact effectively and tactfully with all levels of employees, management staff, patients, vendors and the general public
    • Strong computer and phone skills, including Microsoft Office Suite experience
    • Responds timely to requests, emails, voicemails, etc.
    • Ability to handle multiple simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner
    • High integrity, including maintenance of confidential information
    • Regular and reliable attendance
    • Exercises professional judgment and demonstrates good problem-resolution skills
    • Eagerness and ability to work independently as well as part of a team with flexibility and willingness to learn and take initiative on variety of tasks and projects
    Education & Experience:
    • Must have high school diploma or general education degree (GED)
    • 3 plus years' relevant work experience in healthcare, preferred
    • Knowledge of insurance plans and their rules
    • Basic CPT and ICD-10 coding knowledge
    • Working knowledge of EMR and/or billing systems
    • If required to travel for company related purposes:
    • Active, valid driver 's license
    • State minimum coverage vehicle insurance
    • Must be able to pass driving history/motor vehicle check upon hire and maintain an acceptable record thereafter
    Benefits:
    • Competitive compensation
    • License and DEA Reimbursement
    • Annual Education/CME reimbursement
    • Comprehensive Health/Vision/Dental insurance options
    • Great PTO plan PLUS Paid Holidays
    • 401k and matching available
    Commonwealth Pain and Spine is an Equal Employment Opportunity Employer
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