Franklin, TN

PhyNet Dermatology has an IMMEDIATE NEED for the top Denials Specialists to join our team! If that's you, we invite you to apply to today! The A/R Denials Specialist is responsible for all aspects of insurance follow up and denials, including making telephone calls and accessing payer EOBs.

Responsibilities:

Monitor commercial, government, and specialty payer claims to ensure timely follow up and claims resolution.
Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
Make changes to demographic information as necessary to produce a clean claim.
Meet or exceed productivity standards in the completion of daily assignments and accurate production.
Responsible for reviewing and understanding medical records, provider notes, Explanation of Benefits, etc. for knowledge of appeal or account resolution.
Facilitates and initiates appeals to insurance companies for claim resolution.
Handles correspondence requests from payers to ensure all information that is required for claim processing is provided in a timely manner.
Analyze coding to ensure proper billing of claim. Experience with claims follow up, denial posting, claim processing, and appeals.
Adhere to quality and productivity standards assigned by management.
Ensure statements are generated for the patient responsibility amounts.
Utilize insurance websites to view and resolve claims.
Perform extensive account follow-up and provide analysis of problem accounts.
Document all follow up efforts in a clear and concise manner into the AR system.
Audit and research accounts, payment and contractual postings, and patient payments to confirm the accuracy of the balance of the account.
Ability to identify and report payer trends that may provide insight into payment challenges. Collaborate with management on difficult or reoccurring denials.
Phone contact with patient, physician office, insurance company, etc. for additional information to process the claim.
Ability to assign CPT/ICD-9/10 and HCPCS codes from surgical/progress note.
Attention to detail with the ability to identify/resolve problems and document the outcome.
Regular and reliable attendance.
Strong telephonic communication skills with a pleasant and friendly demeanor.

Join us if you have:

Denials/follow up experience REQUIRED!
Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
Knowledge of general insurance requirements, working denials, and submitting appeals.
Experience working directly with EOBs and contractual adjustments.
General computer knowledge, working with electronic filing.
Ability to communicate verbally/in writing with professionalism.
Ability to meet productivity expectations