Resolution Analyst, Denials
Core
Facilitate payment review recovery efforts for denied and underpaid accounts by appealing claims to payers and collecting cash payments from insurance companies.
Role type
Resolution Analyst (Healthcare Revenue Cycle)
Builds
Cash payments and accurate reimbursement for assigned clients
Domain
Healthcare / Revenue Cycle Management
Deliverable
client delivery
Required skills
Healthcare billing and collections, Insurance claims processing, Medical coding (ICD, HCPCS/CPT), Hospital contract review, Revenue cycle process knowledge, Managed care contract analysis, Medical terminology, Office applications (MS Office), EOB and billing form analysis (UB04, HCFA 1500)
Preferred skills
Associate or Bachelor's Degree, Client-facing/customer service experience
Responsibilities
Review, evaluate, appeal, and follow up on outstanding, denied, and underpaid claims; Use payment documentation and provider contracts to determine correct reimbursement; Research and acquire medical records to submit complex underpayment appeals; Conduct telephone follow-up with payers to resolve outstanding receivables; Ensure smooth operations and improve customer satisfaction. (via careerplan.io/jobs/acfe400e-41c0-42df-9576-9b382a498f39-resolution-analyst-denials-at-enablecomp)