• Appeals and Denials

    Job Locations US-TX-Dallas
    Req No
    2018-4618
    Category
    Production Coding
    Type
    Perm Placement
  • Overview

    The Denials & Appeals review all denials, obtain additional information as needed and files necessary appeals to resolve payor denials. Forward claim denials to appropriate departments when additional information is needed.

     

     

    Responsibilities

     

    • Monitor Advanced Beneficiary Notices and denials as it relates to medical necessity requirements.
    • Identify and evaluate denials to determine specific issues and patterns that need to be addressed with the facility.
    • Investigate all payer denials and take appropriate action including but not limited to appeals, corrected billing and chart reviews.
    • Document patient accounting system with all denial activity and actions taken.
    • Compile monthly denial reports.
    • Maintain all data elements related to denials in the Compliance 360 module.
    • Other duties as assigned by supervisor

     

    Qualifications

    Must be able to communicate effectively with strong attention to details and problem solving both verbally and written. Strong telephone communications skills are required.

    Ability to prioritize work and meet deadlines is required. Knowledge of general office procedures is required. Ability to operate common computer systems, utilize hospital collection system and business software is required.

    Reasoning Ability: Ability to define problems, collect data, validate data, establish facts, and draw valid conclusions.

     

    AMN Healthcare company, is an EEO/AA/Disability/Protected Veteran Employer We encourage minority and female applicants to apply

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed