Patient Accounts - Denials Specialist - FT Job Listing at Wilson Health in Sidney, OH (Job ID 8a78879e902d785101905a9d1bf24969)

Description

Wilson Health is looking for a direct hire Denials Specialist for our Patient Accounting Department located in Sidney, Ohio (North Dayton, Ohio) area.   Key Perks and Benefits:

• Access to Employer Direct Care Clinic.  Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
• Generous paid time off program beginning day one
• Medical Insurance: Your Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance
• H S A with employer contribution for eligible health plans, FSA for medical and dependent care expenses
• Company Paid Life, Short Term and Long Term Disability Insurance
• Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance
• Industry leading retirement plan- employer contributions begin day one, no waiting period for participation
• Tuition Assistance Program

Employment Status: Full Time (FT=36+ hours) Working Hours: 40 hours a week (80 hours per pay period) Schedule: Monday - Friday (No Weekends or Holidays) Shift: 1st shift (7:30AM-4PM or 8AM-4:30PM)   Position Reports to: Manager of Patient Accounts                            Department Description: Wilson Health's Patient's Account Department is responsible for handling the hospital billing and collection aspects of the patient's care during the service date (The date/date(s) when care was provided to the patient from the hospital or provider).   Job Summary: Under the directions of the Director/Manager of Patient Accounts the Denials Specialist will follow up on electronically and mailed hard copy UB/1500 claims that have denied for No Auth, Medical Necessity, Procedure not Covered by Payer, Provider Out of Network, Coding Errors, and any other technical denials. The Denials Specialist will rebill or Appeal claims as indicated.    Essential Duties & Responsibilities: Other duties may be assigned.

• Keep up to date with Payer Policies, Requirements and/or Edits.
• Works closely with all departments throughout the hospital regarding charges and/or late charges.
• Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons.  
• Appropriate follow up on denial/appeal/until payment received
• Works with Case Management and Medical Records regarding RAC audits, other audits, requesting medical records, and inpatient denials.
• Works mail as it applies to Denial Specialist to secure payment.
• Works closely with Central Scheduling/Registration, Case Management and Medical Records regarding Denials for No Authorizations and/or Medical Necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal.

Other Skills and Abilities: 

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill and/or ability required.   Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  The ability to communicate with a professional friendly personality to the customer is essential.   Internet skills and the ability to navigate through different systems.
• Accurate typing skills, computer keyboard skills and data entry.   Knowledge of medical terminology, CPT and HCPCS codes.  Calculator skills.  Ability to work in a highly stressful environment.  Ability to adapt to change.   Knowledge of Excel.   Organization and prioritizing skills.   Ability to communicate with co-workers.

Qualifications:

• 2+ Previous Hospital/Physician billing experience. Medical terminology and understanding of CPT and HCPCS codes
• High school diploma or general education degree (GED)

Mission & Vision & Values:

• Improve the health and wellness of the community by delivering compassionate, quality care.
• Be a trusted, nationally-recognized leader of innovative, collaborative, community health.
• A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence.

EOE (Equal Opportunity Employer)

 Apply on company website