Patient Accounting Denials Specialist I- Business-Office Physician Services
Patient Accounting Denials Specialist I- Business-Office Physician Services
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Job Description
Overview
Now Hiring a Patient Accounting Denials Specialist I BusinessOffice Physician Services
Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties including A/R followup appeals customer service processing of correspondence and daily reconciliation of activities.
How you belong matters here.
We value our employees differences and find strength in the diversity of our team and community.
At Presbyterian its not just what we do that matters. Its how we do it and it starts with our incredible team. From Information Technology to Food Services and beyond our nonclinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us
- Full Time Exempt: No
- Job is based at Rev Hugh Cooper Admin Center
- Work hours: Days
- Benefits: We offer a wide range of benefits including medical wellness program vision dental paid time off retirement and more for FT employees.
Ideal Candidate: Minimum two years experience in insurance followup billing and collections.
Qualifications
- High school degree or GED required shortterm training on insurance collections and claims processing. Minimum two years experience in insurance followup billing and collections. Demonstrated ability to communicate effectively via telephone and in writing and be computer literate.
- Must be passionate about being part of an organization focused on continuously improving patient experiences and the health of our community.
- Experience with Microsoft Office Suite products preferred. Excellent organizational problemsolving verbal and written communication skills along with attention to detail and the ability to interact effectively with other functional areas and management teams are required.
- Must have a strong work ethic and demonstrated ability to work effectively in a team environment.
- Must be able to prioritize and manage a highvolume workload and be able to work in a fastpaced environment and contend with continually changing payer regulations and requirements.
Responsibilities
- Performs denial followup activities for assigned payors utilizing work queues.
- Submits corrected claims reconsiderations and/or appeals to overturn denials.
- Responsible for providing any information (medical records itemized statements etc.) requested by insurance companies to process claims and overturn denials.
- Must follow process/procedures to ensure timely follow up on outstanding denials.
- Document accounts in accordance with established PHS policies/procedures.
- Knowledgeable in various computer systems (i.e. Electronic Health Record claims clearinghouse FISS/DDE Payer portals Microsoft Office Suite.)
- Must utilize communication skills to be an effective team member.
- Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns.
- Must develop and maintain professional work relationships with team members PHS departments and outside agencies.
- Maintains strictest confidentiality adheres to all HIPAA and CMS compliance rules and regulations.
- Perform other duties as assigned by the Denial Supervisor and/or Manager.
Benefits
We offer more than the standard benefits!
Presbyterian employees gain access to a robust wellness program including free access to our onsite and communitybased gyms nutrition coaching and classes wellness challenges and more!
Learn more about our employee benefits:
Why work at Presbyterian
As an organization we are committed to improving the health of our communities. From hosting growers markets to partnering with local communities Presbyterian is taking active steps to improve the health of New Mexicans. For our employees we offer a robust wellness program including free access to our onsite and communitybased gyms nutrition coaching and classes wellness challenges and more.
Presbyterians story is really the story of the remarkable people who choose to work here. The hard work of our physicians nurses employees board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875000 New Mexicans.
About Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients members and the communities we serve. We are a locally owned notforprofit healthcare system of nine hospitals a statewide health plan and a growing multispecialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 14000 employees including more than 1600 providers and nearly 4700 nurses.
Our health plan serves more than 580000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.
About Our Regional Delivery System
Presbyterians Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis Espanola Ruidoso Santa Fe Socorro and Tucumcari. Our regional facilities are home to more than 1600 clinical and nonclinical employees who help make Presbyterian the states largest private employer with nearly 14000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care our regional employees are proud to provide closetohome care for their communities.
We are part of New Mexicos history and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.
About New Mexico
New Mexico continues to grow steadily in population and features a low costof living.
Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture from mountains forests canyons and lakes to caverns hot springs and sand dunes.
New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path challenge your body in the elements or open yourself up to the expansive sky. From hiking golfing and biking to skiing snowboarding and boating its all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drugfree and tobaccofree employer with smoke free campuses.
Maximum Offer for this position is up to
Compensation Disclaimer
Required Experience:
Unclear Seniority
Employment Type
Full-Time
