Denials Management Follow Up Representative

📋 Description

• Coordinate denial and appeal follow-up activities to ensure third-party payors respond promptly and
• Contact insurance carriers to investigate outstanding appeals, clarify payment decisions, resolve
• Monitor daily denial management and appeal follow-up activities, collaborate with relevant
• Maintain the denial management tracking application, including activity records, user access
• Collect, organize, and analyze information from multiple systems to produce regular status reports
• Maintain complete, accurate, and easily retrievable records of denial activity, appeal submissions

🎯 Requirements

• 5-7 years of experience in a healthcare patient accounting or revenue cycle environment, with
• Bachelor's degree or an equivalent combination of education and relevant professional experience.
• Strong understanding of hospital revenue cycle management, including electronic data interchange
• Understanding of government and managed care billing requirements, insurance coverage policies
• Ability to interpret electronic and paper Explanation of Benefits (EOB) documents and payor 835
• Familiarity with Correct Coding Initiative (CCI) edits, Current Procedural Terminology (CPT)

🎁 Benefits

• Fully remote position based in the United States.
• Stable, full-time opportunity within a healthcare organization focused on patient care, research
• Eligible employees receive medical, dental, and vision insurance.
• Retirement savings plan with employer matching, subject to applicable plan terms.
• Educational support to encourage professional development and continued learning.
• Contribute to the financial operations supporting specialized pediatric healthcare and services for