Clinical Denials Specialist
2 days ago
Visaya KPO is seeking a highly skilled Clinical Denials Specialist to join our team. As a Clinical Denials Specialist, you will be responsible for verifying patient eligibility and authorization, researching and resolving unpaid or denied claims, and communicating with payers to secure payment of claims.
Key Responsibilities:- Verify patient eligibility and authorization using payer websites, client eligibility systems, or via phone with insurance carriers/providers
- Research and resolve unpaid or denied claims, including EOBs for payments or adjustments
- Communicate with payers via phone or written correspondence to secure payment of claims
- Access client systems for payment, patient, claim, and data information
- Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
- 3+ years of medical collections, denials, and appeals experience
- At least 6 months of EPIC tool experience
- Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI
- Intermediate knowledge of third-party billing guidelines
- Intermediate knowledge of billing claim forms (UB04/1500)
- Intermediate knowledge of payor contracts - commercial and government
- Intermediate working knowledge of Microsoft Word and Excel
- Intermediate knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
- Intermediate knowledge of DDE Medicare claim system
- Intermediate knowledge of government rules and regulations
- 15% Night Differential
- HMO Benefits after 30 days + Add Up to 2 Dependents
- Retirement Benefits
- 24 Leave Credits per year, Convertible to Cash
- Wholistic Employee Wellness Program
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Clinical Denials Specialist
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Clinical Denials Specialist
2 days ago
Pasig, National Capital Region, Philippines Visaya KPO Full timeJob DescriptionWe are seeking a highly skilled Clinical Denials Specialist to join our team at Visaya KPO. As a key member of our revenue cycle team, you will be responsible for verifying patient eligibility, researching and resolving unpaid or denied claims, and communicating with payers to secure payment.Key Responsibilities:Verify patient eligibility and...
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