Reimbursement Specialist - Healthcare jobs in Michigan

Description

Who we are: Advanced Radiology Services is one of the largest 100% physician-owned and managed radiology practices in the country. Our growing practice includes 214 radiologists, 44 advanced practice providers, and over 200 employees providing administrative support in our wholly owned subsidiary STARS. We value diversity on our team and promote a culture of inclusion. 

What we are looking for: The Denials Project Specialist will play a key role in reducing and maintaining the Days in AR in accordance with the annual goal not only by working denied claims, staying current on coding and insurance company payer rules but also by strategically working with the Director in the development of proactive system build, progresses, and/or training that will result in reduced denials for the company.

Responsibilities:

• Watch for denial trends, identifies and reports out trends.
• Analyzes denial reports, EOB's to identify opportunities for proactive improvements
• Conducts necessary claim appeals to insurance companies, adhering to the appeals process of each payer.
• Researches system functionality to create rules to eliminate denials proactively.
• Reviews current training materials to determine if there are missing steps to proactively prevent denials.
• Using SBAR, prepares proposals for Director based upon analysis.
• Reads publications and payer notification related to denials and shares information with applicable manager and supervisor to share with team.
• Additional duties as assigned.

What’s great about working for STARS?

• Important Work-Because of the great behind the scenes work that you do- our company can provide outstanding radiology services to so many patients in Michigan. 
• Stability- This practice has gone through significant growth and is here to stay. 
• Work/Life Balance/Flexibility- Many of our positions work from home or in a hybrid schedule!
• Outstanding Benefits- We have a 7.5% 401k contribution! (wait it’s not even a match?)
• Culture- It’s built on transparency, support and recognition! We call out good work. 
• Click here to learn more from our employees: https://www.advancedrad.com/careers/ Scroll to STARS Employee Survey      Feedback 2022

Requirements

• High school diploma or GED equivalent required; Associate’s or Bachelor’s degree in Billing, Anatomy, Healthcare, or Management is preferred
• CPC certification preferred with 2-3 years of experience working coding denials in a billing office setting 
• Healthcare management and/or supervisory experience of 2 years
• Experience in proactive resolution of denials utilizing billing system functionality
• Experience in proactive resolution of denials through training and processes