Denial Management Specialist (Medical Billing)

EvergreenHealth is seeking a Denial Management Specialist to investigate and resolve health plan denials to ensure appropriate actions are taken. This role involves correcting claims, adjusting denials, coordinating with payers, and analyzing denial patterns to improve processes and contribute to a comprehensive denial management program.

Requirements

• Investigates insurance denials to identify action necessary.
• Corrects claims based on denials, complaints and audits and rebills using payor approved process.
• Determines need for payor appeal and sends individualized appeal letter.
• Adjusts denials based on the corresponding adjustment code(s).
• Works the accounts that meet denial management criteria and coordinates resolution with other departments.
• Logs all denials on Denial spreadsheet.

Benefits

• Medical, vision and dental insurance
• On-demand virtual health care
• Health Savings Account
• Flexible Spending Account
• Life and disability insurance
• Retirement plans
• Tuition assistance
• Federal Public Service Loan Forgiveness program
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidays
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits