Patient Accounting Denials Specialist I

Patient Accounting Denials Specialist I

Location Address:

9521 San Mateo NE Albuquerque, NM 87113-2237

Compensation Pay Range:

Minimum Offer $16.66 Maximum Offer $26.70 Now Hiring: Patient Accounting Denials Specialist I

Summary:

Build your Career. Make a Difference.

Presbyterian is hiring a skilled Patient Accounting Denials Specialist I- Business-Office Physician Services.

Responsible for root cause analysis and next step resolution of denials. Performs a variety of duties, including A/R follow-up, appeals, customer service, processing of correspondence, and daily reconciliation of activities.

Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America)

Responsibilities

• As a Patient Accounting Denials Specialist I, you will perform denial follow-up 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.

Qualifications

• High school degree or GED required, short-term training on insurance collections and claims processing. Minimum two years experience in insurance follow-up, 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, problem-solving, 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 high-volume workload and be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.

• All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

• Wellness

• Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

• 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.

• About Presbyterian Healthcare Services

• Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

• Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

• AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

• We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services