Clinical Denials Specialist

Clinical/Medical Research (Healthcare & Medical)
Job Opportunity: Clinical Denials Specialist Are you passionate about ensuring accuracy in medical billing and compliance? Join us as a Clinical Denials Specialist! Your role involves reviewing patient medical claims, resolving compliance issues, and addressing rejections on the physician's side.
Key Responsibilities: Timely and accurate processing of accounts based on client requirements. Reviewing daily account/edit reports, resolving edits (prior billing) and rejections from payors. Addressing various edits, including Medical Necessity, LCD, NCD, NCCI, Modifier, Payer-specific, MUE, PTP, and Diagnosis issues. Documenting actions taken to reconcile claims in the billing system. Ensuring confidentiality of patient records and adherence to HIPAA compliance. Collaborating as a team player with a high attention to detail. Applying logic and critical thinking for effective problem-solving. Staying updated on industry changes for informed decision-making. Qualifications: Bachelor of Science in Nursing or Medical Allied Health Course. Preferred experience in revenue cycle (medical coding), knowledge of ICD-10, CPT procedures, and clinical or hospital settings. Certification required: AAPC (CPC, COC, CIC) or AHIMA (CCA, CCS-P, CCS). Join us in making a difference! Apply now and be a part of our dynamic team dedicated to excellence in healthcare billing. #HealthcareJobs #ClinicalDenialRepresentative
Your application will include the following questions:
What's your expected monthly basic salary?
How many years' experience do you have as a Medical Coder?
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