Base: $19.76 - $36.75; bonus/equity: not specified...
Not specified
Resolve complex denials
Research account history
Resubmit corrected claims
AdventHealth is seeking a Denials Management Specialist to handle complex claims denials, conduct research, and communicate effectively with leadership. The role requires strong organizational skills and knowledge of medical billing, while offering comprehensive benefits and a supportive work culture
Job Summary
Reviews and resolves accounts daily, focusing on complex denials across multiple payers and regions.
Defends and appeals denied claims by researching root causes, collecting necessary information, adjusting accounts, resubmitting claims, and following up to ensure adjudication.
Understands managed care payment methodologies and principles, interpreting multiple payment methodologies for various payer types.
Matching Summary
Match Score: 85
AdventHealth is seeking a Denials Management Specialist to handle complex claims denials, conduct research, and communicate effectively with leadership. The role requires strong organizational skills and knowledge of medical billing, while offering comprehensive benefits and a supportive work culture.
Salary
Base: $19.76 - $36.75; Bonus/Equity: Not specified; Benefits: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance, Paid Time Off, 403-B Retirement Plan, Parental Leave, Career Development, Well-being Resources, Mental Health Resources, Pet Benefits
Skills & Requirements
Must-have
Resolve complex denials
Research account history
Resubmit corrected claims
Interpret payer contracts
Analyze payer performance trends
Understand EOBs
Proficiency in Microsoft Suite
Nice-to-have
Navigate payer websites
Experience with 835/837 files
Familiarity with UB04/CMS-1500 forms
Comfort with payer contractual language
Key Requirements
1+ years experience in billing, a/r follow up, and/or denials management & appeal writing