PT Billing Specialist-Claim Denials
Meadville, PA 16335
PT: 20 hrs per week
Summary of Position: Develop and maintain denials management tracking mechanism, identify denials and record denials into the tracking mechanism, identify trends, provide reports for insurance follow-up and appeals, and other duties as assigned.
Duties and Job Responsibilities:
- Resolve / appeal denials and apply notes to systems
- Submit re-determinations and re-considerations
- Escalate complex claim issues to management
- Track denial trends
- Work with carrier representatives to resolve identified trends
- Assist certified coders with local coverage determinations
- Coordinate with Allegheny College staff regarding student claims
- Participate in scheduled staff meetings
Qualifications, Credentials and Skills:
- Strong organizational skills.
- Verbal and written skills necessary to communicate clearly and professionally with co-workers, patients, insurance companies and physician office personnel.
- Project and maintain a positive image in telephone interactions with patients, insurance companies, and co-workers and maintain an appearance of composure under stressful situations.
- Basic computer, calculator, fax, copier skills.
- Ability to work as a team member of various work groups and multi-disciplinary problem solving teams.
- Ability to hear and communicate via telephone with patients and staff.
- Ability to exercise good judgment, work independently without close supervision and respond to concerns of others with tact.
- Ability to organize and prioritize duties, shifting suddenly to new tasks as priorities change, adjusting work schedule to reflect changing situations and requirements.
- Ability to concentrate in a busy work area.
- Provide professional and friendly atmosphere.
- Observe and comply with company's core values.
- Provide excellent customer service.
- Introduce self when greeting patients and visitors in person or via telephone.
- Follow appropriate chain of command for reporting issues such as grievances, patient complaints and staffing issues.
- Use time effectively.
- Treat all people fairly regardless of age, race, sex, disability, religion, etc.