Denial Reimburse Specialist

Rehab Administration
Franciscan Health

​24 Joliet Street 
Dyer, IN 46311
 

Days; Part-Time Benefit eligible

20 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 denied 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

  • Review denials and payment discrepancies identified through the denial system which are directly related to the verification, authorization and registration process.
  • 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.
  • Conduct inquiries via phone, mail, fax, or electronically to conduct follow up on the accounts that have not been denied and resubmitted for payment.
  • Follow up on all successfully submitted appeals until a determination is made on the appeal.
  • Conduct follow up with insurance, physicians, and any other area that can validate and assist with actions and information needed in order to properly review, dispute or appeal denial.
  • Identify trends of denials, provide documentation and data, and offer suggestions for process improvement to resolve the issue.
  • Maintain timely and efficient follow up on successfully submitted appeals until a determination is made on the appeal.
  • Submit record request to the site and correspondence to patient on requested information.
  • Investigate denials for root cause and report to manager to communicate information back to the sites.
  • Submit all documentation related to appeals, retro authorizations, and referrals to HPF for scanning.
  • Document all follow up activity in denial system for tracking and reviewing purposes.

WHAT IT TAKES TO SUCCEED

  • Communicate clearly and professionally.
  • Strong organization and time management skills.
  • Excellent interpersonal, verbal, and written communication skills.
  • Extensive experience with computers, Revenue Cycle/EDI/Payer sites.
  • Knowledge of Medical and Managed Care Contract terminology.
  • Demonstrated knowledge of Revenue Cycle procedures. 


WHAT WE'RE LOOKING FOR

High School Diploma/ GED Required

1-3 Years Experience

License(s):

Certification(s):

Travel: Never or Rarely

 

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.

Company
Franciscan Alliance Inc
Posted
03/24/2018
Type
Full time
Location
Dyer, Indiana 46311, US