Denial Prevention Specialist

Talent Groups ·www.talentgroups.com

Location Weatherford, TX, United States
Work type Remote
Salary USD 11 - 22 / hour
Type Full time
Level Mid
Source Shazamme
Other East
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Location Details: Primarily remote but may need to go onsite for training, team building events or as requested

Duration: 6 months to start

Job Description
The successful candidate will review, research, and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effort to maximize collections. A successful candidate should have, but not be limited to the following skills:
  • Capable of reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed.
  • Contacting insurance carriers to check on the status of claims, appeals, and insurance verification.
  • Knowledgeable with payors including Managed Care, Commercial, Medicare, and Medicaid
  • Preparing/Submitting appeals related to denied services
  • This is a work from home (WFH) opportunity. The successful applicant must live within the Greater DFW area and be available to come to the office for equipment pickup, office meetings, and training. Additional details regarding WFH will be discussed as part of the interview process.
Job Duties
  • Analyze payer denials by denial groupers and submit appeals.
  • Contact patients and/or third party payers to resolve outstanding insurance balances and underpaid claims.
  • Make necessary adjustments as required by plan reimbursement.
  • Functions as a liaison between clinical departments and MSRDP management team.
  • Completes special projects as assigned.
  • Performs other duties as assigned.
QUALIFICATIONS
Education and Experience
Required
  • Education: High School Diploma or
  • Experience: 2 years experience in medical claims recovery and/or collections required
Preferred
  • Education: Associate's Degree
Knowledge, Skills and Abilities
  • Work requires a self-starter, with ability to work well as part of a team and independently.
  • Work requires ability to communicate effectively with patients, insurance companies, clinical staff and management.
  • Work requires ability to handle large volumes of work.
  • Work requires ability to work in a fast paced, production oriented environment.
  • Work requires excellent customer service skills.
  • Work requires experience in Medical Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment.
  • Work requires good organizational, flexibility and analytical skills when resolving more complex unpaid claims.
  • Work requires knowledge of billing and/or collections and regulations.
  • Work requires knowledge of CMS 1500, ICD-9, and CPT coding is preferred.
  • Work requires one to exhibit excellent work ethics and commitment to job responsibilities.
  • Work requires one to possess a professional and courteous demeanor while being assertive and confident in their collection efforts.
  • Work requires one to possess quick and accurate alpha/numeric data entry skills.
  • Work requires presence of a positive image that reflects well on the organization.
  • Work requires strong written and verbal communication skills.
  • Work requires understanding of the requirements of Medicaid, Medicare and insurance billing.
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Frequently asked questions

Who is hiring for the Denial Prevention Specialist role?
Talent Groups is hiring for the Denial Prevention Specialist position, a Shazamme client. Apply directly on the employer's career site.
Where is the Denial Prevention Specialist job located?
The Denial Prevention Specialist role with Talent Groups is based in Weatherford, TX, US. The role is remote-friendly.
Is the Denial Prevention Specialist role remote?
Yes — the Denial Prevention Specialist position at Talent Groups is remote. Candidates based in US are preferred.
What does the Denial Prevention Specialist role pay?
Talent Groups lists the Denial Prevention Specialist role at USD 11–22 per hour.
Is the Denial Prevention Specialist role full-time or contract?
This is a full time position at Talent Groups.
What experience level is the Denial Prevention Specialist role?
The Denial Prevention Specialist position is aimed at mid-level candidates.
How do I apply for the Denial Prevention Specialist role at Talent Groups?
Apply directly on Talent Groups's career page via the Apply button on this listing. ZammeJobs links straight through to the employer's ATS — no third-party form, no resume database.
Apply direct