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Denial Collections Specialist

Revenue Management Sierra
Franciscan Alliance

​​1040 Sierra Drive Suite 400 
Greenwood, IN 46143
 

Days; Full-Time

40 Hrs/Wk

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WHAT WE NEED

Persistent, organized financial support

WHO WE ARE LOOKING FOR

Some people love getting to the bottom of things -- chasing down claims, resolving accounts, digging through the details to identify discrepancies and needs. Yes, we’re talking about people who love collections. And it takes a love of getting into the details to do this job well.

 

Do you have top notch customer service and data entry skills? Are you good at following through on inquiries? Are you accurate and organized? We’d love to talk to you about working here. 

WHAT YOU WILL DO

  • Daily review of denials and payment discrepancies identified in Denial system fed by 835 files, manually posted R/A’s EOB’s, or Payer Correspondence. 
  • Review of all assigned denied claims and validation of action needed for reconsideration.
  • Resubmit all claims denied due to technical reason and follow up on all claims denied for clinical reason.
  • Insure all clinical denials assigned to Clinicians, Patient Access and/or HIM denial staff are acknowledged in a timely manner and appropriate follow up action taken as defined by the respective policy.
  • Adjust and re-assign denials to the respective biller/collector for processing. The write-off limits will follow the ABO collector guidelines for Write-offs.
  • Ensure follow-up of on denied claims occur on a timely basis and adheres to contractually binding conditions.
  • Identify trends of denials, provide documentation and data, and offer suggestions for process improvement to resolve the issue.
  • Conduct inquiries via phone, mail, fax, or electronically to conduct follow up on the accounts that have not been denied and resubmitted for payment.
  • Contact patients for additional information needed to get claim paid.
  • Maintain follow-up procedures and working relationships with area responsible for the information, including; Medical Records Department, Patient Access, and/or physicians.
  • Document activity in an accurate and timely manner on the patient’s account.

WHAT IT TAKES TO SUCCEED

  • Knowledge of the computer system as it pertains to proper registration through collection functions, including Affinity, Provider Advantage, HWorks, Maxsys, NDC/E’Premis, Denial Management and McKesson HBF or Archive/Fiche.
  • Ensure compliance with all state and federal billing regulations and reports any suspected compliance issues to your respective Manager/Supervisor and Education/QA Manager.
  • Strong customer service skills
  • Proficient computer skills
  • Professional telephone etiquette
  • High attention to detail 


WHAT WE'RE LOOKING FOR

High School Diploma/ GED Required

1-3 Years Experience

License(s):

Certification(s):

Travel: 

 

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.