Overview
Denials Specialist Jobs in City of White Plains, New York, USA at White Plains Hospital
Position: Insurance Denials Specialist
Location: City of White Plains
At White Plains Hospital, you have an opportunity to work side-by-side with some of the most talented people in the world.
We have been widely recognized for our exceptional culture, world-class physicians, Magnet-designated nurses, and passionate employees who make a real difference in our community. With tremendous growth opportunities, great benefits, and flexible work schedules, it is no wonder why we are consistently recognized as aGreat Place to Work
.
Position Summary
The Denials Specialist is responsible for providing various support within the Medical(Hospital Centralized Business)Billing Department. This position involves collecting and managing accounts, following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims when appropriate, and following up on all denials to ensure reprocessing and payment in a timely manner.
Essential Functions and Responsibilities Include the Following:
Understands and adheres to the WPH Performance Standards, Policies, and Behaviors. Processes rejections, denials, and other correspondence received from third-party payers in accordance with WPH procedures and guidelines in an effort to resolve non-payment issues and rebill ‘clean’ claims for payment.
Document accounts worked in Davincian/Meditech.
Responsible for the submission of appeals to third-party payers to recover additional revenue.
Investigate payer rejections and denials.
Work all Denials that pertain to including but not limited to, Duplicate Claim, Timely Filing, EOB requests, Not Medically necessary denials, COB denials.
Responsible for reviewing and trending denial issues, identifying the root cause, and bringing accounts to a final resolution.
Communicate information and make recommendations to improve current processes to eliminate future denial occurrences.
Performs all other related duties as assigned.
Education & Experience Requirements
High school Graduation required. Clerical Experience.
Previous hospital billing/follow-up/denials experience required.
Ability to use basic office equipment and knowledge of CTR computer terminals required.
Medical terminology is helpful but not mandatory.
Core Competencies
The ability to cooperate with others.
Must be able to speak, write, understand, and communicate in the English language.
Effectively communicate with internal and external customers.
Integrity to handle the confidential aspects of work.
Physical/Mental Demands/Requirements & Work Environment
May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital’s SDS (Safety Data Sheet) database and may be accessed through the hospital’s Intranet site (Employee Tools/SDS Access). A copy of the SDS database can also be found at the hospital switchboard, saved on a disc.
Must be able to remain in a stationary position 50% of the time.
The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc.
The person in this position frequently communicates with patients who have questions and must be able to exchange accurate information in these situations.
Must be able to detect and greet patients arriving.
Primary Population Served
Check appropriate box(s) below:
Neonatal (birth – 28 days)
Infant (29 days – less tha…
Title: Denials Specialist
Company: White Plains Hospital
Location: City of White Plains, New York, USA
Category: Healthcare, Administrative/Clerical
