What are the responsibilities and job description for the Denials Specialist position at Shannon Health?
|
Job Summary |
The HIM (Health Information Management) Denials Specialist, under general supervision of the Denials Specialist Manager, performs moderate level work related to claim denial review, correspondence denial/audit review, documentation of denial reason with appeal deadline, and prepare supporting documentation to accompany appeals. Responsible for logging denials and correspondence, submitting provided appeal letters with supporting documentation, providing appeal forms when required, managing appeal submissions, monitoring for appeal responses, notating accounts with appeal actions, and appeal response follow-up including but not limited to, phone calls to the insurance/auditing entity and portal review. Works with the denial team to meet appeal deadlines. Will communicate denial/appeal activities to management and report suspected or emerging trends to management.
|
Education |
|
Education Type |
Program of Study |
Required/Preferred |
|
High School Diploma or GED |
N/A |
Required |
|
Experience |
|
Type of Experience |
Number of Years |
Required/Preferred |
|
Knowledge of Medical Terminology |
>1 |
Preferred |
|
Medical Office Experience |
>1 |
Required |
|
Certification & Licensures |
- None