PT Billing Specialist-Claim Denials

Meadville, PA 16335

Posted: 06/10/2019 Industry: Clerical/Office Job Number: 610196 Pay Rate: $12 hr

 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. 


Other Qualifications:  

  • 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. 


Foundational Values: 

  • 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. 

Dave Sandberg

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