Denial Management Specialist

Overview

Blue Ridge Health is currently seeking a Denial Management Specialist to be part of our Patient Financial Services Team.

What We Offer You:

• A competitive benefits plan, including Medical, Dental and Vision
• Company sponsored life insurance and short and long-term disability coverage
• 403(b) retirement account with company matching
• Supplemental accident insurance available
• 7 paid holidays per year
• PTO and Personal Day accrual, starting day 1 - (We value a work-life balance!)

What You'll Do:

• Obtain explanation of benefits (EOB) forms from the Cash poster.
• Review denial codes on EOB forms.
• Identify what type of error has caused the denial.
• Identify charges that need clarification or update.
• Correspond with appropriate department, billers, coders and providers for any questions pertaining to the denial.
• Research websites for additional information pertaining to the denial.
• Ensure that any corrected codes are entered into the electronic health record (E.H.R) by the Coding Specialist.
• Ensure that any corrected demographic information is keyed on the ticket by the Biller or Patient Access Representative.

What We're Looking For:

• High School Diploma or equivalent.
• Familiarity with filing insurance claims, denial codes, and insurance regulations.
• Familiarity with CPT codes and medical terminology.
• Familiarity with utilizing Microsoft office products (i.e. word, excel)
• Familiarity with utilizing multi-line phone systems, copier, scanner, fax and other office equipment.

About Blue Ridge Health:

At Blue Ridge Health our mission is to improve Health, inspire Hope, and advance Healing through access to Compassionate, Affordable, and Quality Care. We are seeking individuals with a passion for creating an exceptional patient and client care experience to join our team! We are a nonprofit system of Federally Qualified Health Centers (FQHCs) that works closely with communities to meet the ever-changing medical and behavioral healthcare needs of individuals throughout WNC.

COVID-19 Vaccine Requirement: At Blue Ridge Health, the health and safety of our employees, clients and patients is our top priority. That’s why all offers of employment are contingent on verifying that candidates are fully vaccinated against COVID-19, in accordance with federal mandates. Individuals may submit a request for exemption from the vaccine requirement for medical reasons or sincerely held religious beliefs.

At Blue Ridge Health, we provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.