Denials Management

4 weeks ago


Gurugram, India staffhire Full time

JobOverview:

Weseek an experienced and highly motivated Denials Specialist to joinour team. TheDenials

Specialist willbe responsible for handling denied claims making outbound calls toinsurance

payers andresubmitting corrected claims. The ideal candidate should possessexcellent

communicationand problemsolving skills have a strong understanding of medicalbilling and

coding andbe wellversed in denial management and appealsprocesses.

Role&responsibilities

DenialIdenti cation and Analysis: Identify categorize and analyze denialsand

underpayments fromExplanation of Bene ts (EOBs) and Electronic RemittanceAdvice

(ERAs).

ClaimResubmission and Appeals: Correct and resubmit denied claims orprepare and

submitappeals following payer guidelines andtimelines.

PayerCommunication: Communicate with insurance companies to resolveissues leading

todenials and ensure accuratereimbursement.

PreventativeAction: Review denial trends and work with other RCM teams toimplement

processes thatcan prevent futuredenials.

Experience inanalyzing and resubmitting Denials in multiple specialities(Denials due to

MedicalCoding Authorisationetc).

Preferredcandidate prole

16 years ofprior experience in denials management healthcare billing or arelated role.

Strongunderstanding of medical billing processes payer requirements andCARC/RARC

codes.

Excellentproblemsolving and negotiationskills.

Detailorientedwith strong analyticalskills.

Excellentcommunication skills both written andverbal.

Pro ciency inusing healthcare billing software and Microsoft O ceSuite.

healthcarebilling,appeals processes,carc/rarc codes,microsoft officesuite,review denial trends,calls to insurance payers,medicalbilling processes payer requirements



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