GENERAL STATEMENT OF DUTIES:
The Denials Management Follow-up Specialist is responsible for working all assigned accounts and denials for complex appeals for government and non-government accounts and bring to an appropriate resolution in accordance with regulatory, legal, and compliance guidelines. Additional rules must be followed for overturning appeals and rejections for these accounts. Additional research and coordination with other internal departments and externally with physician offices and insurers is required. These duties are in additional to financial counselor follow-up responsibilities. Assists PFS Director in maintaining AR at appropriate levels.
High school graduate or equivalent is required. Minimum of three (3) years of experience in a hospital or physician billing office. Knowledge of medical terminology and billing/collection practices preferred.