What are the responsibilities and job description for the Denials Analyst position at truecent Solutions?
"Duties:
Responsible for researching and resolving claim denials, ADR requests and certs, submitting and tracking appeals, noting trends and providing monthly reports.
Responds to audit requests (including RAC) from payors.
Maintains a Library of Payer reference material regarding requirement for pre authorization, medical necessity and documentation requirements.
Works with the Revenue Cycle stakeholders (e.g. Admitting, Coding, Provider Liaisons, etc.) to provide information related to denials and opportunities for future denials.
Roles and Responsibilities:
Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations
Analyze denied, underpaid and unpaid claims. Appeal underpaid and denied claims within timely filing periods
Identify, track and report on denial trends
Maintain an appeals data base to identify and report outcomes and opportunities
Identify any billing and/or coding trends resulting in denials and report to the Coding manager
Identify any other trends resulting in denials and report to Manager.
Attend all available coding and appeals related seminars as available
Minimal/ No Potential
Education:
Required: High School diploma or equivalent
License and Certification:
Preferred: Certified coder or currently enrolled in a coding program
Experience required:
Required: Minimum of two years of Professional Billing with an emphasis in Managed Care denial follow up and appeals processing Prior hospital billing experience a plus.
Preferred: three to five years of Patient Accounting in a high volume environment.
Skills required:
Strong Analytical skills, Proficient in Microsoft Windows with emphasis on Excel.
Ability to prioritize and coordinate workflow and attention to detail.
Knowledge of CPT, HCPC and ICD 10 coding requirements with emphasis on modifiers and diagnosis association.
Working knowledge of LCD’s, NCCI and MUE edits as well as a general knowledge of Commercial, HMO, and Medicare Advantage claims, authorization and documentation requirements.
Shift timings: 09 AM - 05 PM
"
Job Types: Full-time, Contract
Pay: Up to $22.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
- Day shift
Experience:
- ICD-10: 1 year (Preferred)
Ability to Commute:
- Rancho Mirage, CA 92270 (Required)
Ability to Relocate:
- Rancho Mirage, CA 92270: Relocate before starting work (Required)
Work Location: In person
Salary : $22