Lancaster General Health Denials Management Specialist in Lancaster, Pennsylvania

Denials Management Specialist

Account:

Lancaster General Medical Group

Facility:

Burle Industries Building BURLELM

Department:

Professional Billing Services

Grade:

G07

Benefits Class:

4

Schedule:

Full-time

Shift:

Day shift

Hours:

80hrs/2wks; flexible shift from 5am-6pm; no hol/wknd

Job Details:

  • This position is located in Lancaster, PA. ATTENTION: Please be aware that, if you are an external applicant, you may need to complete an online assessment as part of the hiring process. This assessment will be sent to the e-mail address that you included in your application. Please note: Some e-mail accounts may receive the assessment e-mail in their junk/spam e-mail. This assessment must be completed within 5 days of receiving it. For more information regarding the assessment, please click HERE. SUMMARY: Lancaster General Health/Penn Medicine is currently seeking a full-time Denials Management Specialist in our Professional Billing Services department. The Denials Management Specialist maximizes cash collections and resolution of aged accounts through informed and consistent follow up activities. The Specialist is also responsible for the timely billing and follow-up of assigned accounts and for ensuring all accounts are paid correctly according to insurance contract terms. The employee must consistently identify account deficiencies that require subsequent follow-up to ensure that all deficiencies are resolved. Hours include a flexible start time within regular day shift hours and no holidays or weekends. This position is located at Burle Business Park. PRIMARY FUNCTIONS: · Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve denial. Provides missing or additional information if necessary, to expedite the resolution of the denied claim. · Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve denied claims. · Processes required adjustments to accounts, including charges credits, payment transfers, policy adjustments, etc. in a timely and accurate manner. · Maintains a thorough knowledge and understanding of all assigned payor contracts and requirements. · Performs research to ensure current policies, applicable coding and insurance guidelines, regulations and laws are being followed. REQUIREMENTS: · High School diploma or equivalent. · Strong written and verbal communication skills. · Ability to apply strong analytical qualities. · Strong critical thinking, time management and organizational skills. · Microsoft Office experience. · Associate's degree preferred. · 1-2 years in hospital, billing or finance experience preferred. · Knowledge of healthcare or healthcare insurance preferred.