Denials management Specialist

Roles and Responsibilities :

• Manage appeals process from start to finish, ensuring timely resolution of denied claims.
• Identify and address root causes of denials through thorough analysis of EOBs (Explanation of Benefits) and provider feedback.
• Collaborate with internal stakeholders to resolve rejections and optimize AR calling strategies for improved cash flow.
• Develop and maintain effective communication channels with providers, insurance companies, and other relevant parties.

Job Requirements :

• 5-15 years of experience in US healthcare industry, preferably in denial management or related field.
• Strong understanding of appeals process, including regulations and guidelines governing medical billing practices.
• Proficiency in analyzing complex data sets to identify trends and areas for improvement in denial rates.
• Excellent communication skills for effective collaboration with cross-functional teams.