Job Description
Denials Specialist
Job Summary
The Denials Specialist is responsible for the follow-up and collections of accounts on the accounts receivable. This includes general payer collections and denial follow-up. In addition, this role could oversee the intake of patient calls. This position performs various accounting, customer service, and organizational tasks to promote the financial health of the organization.
WHAT YOU WILL BE WORKING ON:
- Accounts Receivable follow-up, including collections and denials resolution
- Requires direct calling to payers and use of payer portals
- Working in Patient Account system, managing work queues, and using Excel documents
- Credit balance resolution
- Ability to interpret a variety of EOBs to reconcile patient accounts, determine appropriate balances, and take action for refunds or takebacks
- Place outgoing calls to insurance companies to resolve outstanding claims/balances
- Working knowledge of Medicare, Medicaid, Government, and Commercial payers
- Ability to trend and communicate payer scenarios
- Perform month-end close procedures within established time frames
- Communicate payer and account issues to Manager in a timely manner
- Monitor accounts for other opportunities (e.g., copay, deductible, and coinsurance)
- Enter appropriate comments in the software system clearly and concisely for tracking and documentation
- Ensure adherence to HIPAA standards and all other privacy and compliance policies
- Stay knowledgeable on payer/contract updates and bulletins
- Perform other duties as assigned to support the financial health of the organization
KNOWLEDGE, EDUCATION, AND SKILLS REQUIREMENTS:
- High school diploma or equivalent
- Previous healthcare experience in Accounts Receivable Management
WHAT WILL MAKE YOU AWESOME:
- Excellent written and verbal communication skills
- Excellent computer skills, including Excel, Word, and RCM systems as needed
- Highly organized, detail-oriented, strong work ethic, and demonstrated teamwork skills
- Ability to multi-task and meet deadlines
WHAT YOU KNOW:
To be successful in this role, you will have the following experience or knowledge:
- Ability to read various EOBs
- Experience with payer portals
- Knowledge of Medicare and Medicaid processes
About Midwest Vision Partners (MVP)
Midwest Vision Partners (MVP) is a leading management services organization supporting premier eye care practices across the Midwest. Our mission is to deliver world-class support services to our network of ophthalmology and optometry providers, enabling them to focus on what they do best-providing exceptional patient care. We are proud to support a growing community of practices and surgery centers committed to clinical excellence and compassionate service.
The identification of Duties and Responsibilities does not display an exhaustive list of all duties that may be assigned to this position, nor does it restrict the related work that may be assigned to this position.