Denial Management Specialist I
Nemadji is looking for a skilled individual with knowledge in the healthcare industry. This is a full-time, salaried position with excellent benefits. If you are an individual who has strong knowledge in clinical and technical claim denials and enjoys working in a fun yet challenging environment, then inquire to join our team dedicated to making a difference for healthcare facilities, providers and patients.
- Review, research, appeal and resolve denials for all payers and service areas, all levels and types of denials, including: medical necessity, coding, bundling, concurrent care, frequency, limited coverage, etc.
- Provide clinical argument using available medical records to justify appeals and disputes over payer denials.
- Identify root causes of denials and assist in developing monthly case studies.
- Remain updated and current on all relevant regulatory, accreditation, coding, billing and reporting requirements.
Required Qualifications and Skills:
- High School Diploma
- At least two years of experience
- Strong knowledge of clinical and technical claims in denial management, healthcare billing and collections, medical record contents and knowledge of coding and coverage determinations.
- Ability to plan, prioritize and resolve complex work claims.
- Ability to work independently and with a team in a technology dependent, fast paced and high-volume environment with an emphasis on accuracy and timeliness.
This posting closes on May 7th, 2021.
Send resumes & application requests to:
P.O. Box 100
Bruno, MN 55712