Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions and appeals with the goal of overturning denials and securing payment from insurance carriers.
This role supports revenue maximization for the division and involves working in a fast-paced clinic environment with patients with developmental disabilities.
Requirements & Qualifications
- 3 to 5 years of progressive experience in appeal and denial management preferred
- Strong knowledge of health plan requirements
- Strong analytical and statistical analysis skills
- Experience with EPIC, Microsoft Excel, Word, and PowerPoint
- Knowledge of federal, regional, and state payer coverage patterns, including CMS, fiscal intermediary, and administrative policies
- Strong organizational and communication skills
- Professional demeanor and ability to work with all levels of staff
- Associate's degree required, preferably with medical billing experience
- Bachelor's degree preferred
- Certified Professional Coder (CPC) required
- EPIC Cadence, HB, and PB certifications preferred
- Knowledge of CPT coding and ICD-10 diagnosis coding required
- Ability to multitask effectively in a fast-paced clinic environment
Location
New York, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$49,920 - $62,400
Remote work allowed
No
Posted
5 months ago