Denials Recovery Specialist
Company: United Health Services
Location: Binghamton
Posted on: May 10, 2022
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Job Description:
Denials Recovery Specialist, BinghamtonUnited Health Services is
seeking a Denials Recovery Specialist to join our Revenue Cycle
Team in Binghamton, NY. Denials Recovery Specialists key duties is
focusing on claims denied and aged denials over 90 days from date
of service.Shift: Days Hours per week: Per Diem Salary range:
$17.85 - $24.15/hour, depending on experience----Denials Recovery
Specialist Overview Under the direction of the Denials Manager the
Recoveries Specialist is Responsible for validating dispute/denied
claims reasons as adjudicated from Patients Insurance Explanation
of Benefits Review. Key duties will be focusing on claims denied
and aged denials of 90+ from the original DOS. Responsibilities
will include calling payors to confirm key denial reasons and
solutions to adjudicate the resolution for the denied claim.
Denials Recovery Specialist Key Responsibilities and Expectations+
Validate denial reasons codes via remittance inquires or cart codes
+ Ensure coding is reviewed/corrected as necessary for resubmitting
denied claims for payment + work to final resolution for aged
denials greater than 90 days from date of service + Generate an
appeal based on the dispute reason and contract terms specific to
the payor to include online reconsiderations. + Follow specific
payer guidelines for appeals submission + Evaluate charges entry
and contractual reimbursement to ensure correct payment
transactions are accurate and not over/under paid. + Escalate
exhausted appeal efforts for resolution + Works assigned payer
projects as directed + Preforms research and tracks trends of
accounts worked to create process improvement or Margin Improvement
for trends identified related to User, System and Payor related
issues. + Demonstrate commitment to organizational Values of
Compassion, Trust, Respect, Teamwork, and Innovation Position
QualificationsMinimum:+ High School Diploma or equivalent, with 3+
years of revenue cycle/ and or/ denials experience + Intermediate
understanding of Explanation of Benefits form (EOB) + Federal and
NY State Billing Requirements + knowledge of hospital billing
AND/OR Physician form requirements (UB-04/HCFA-1500) + Strong
understanding of ICD-10, HCPCS/CPT coding and medical terminology +
Intermediate Microsoft Office (Word, Excel) skills + Intermediate
business written communication to include correct use of grammar,
tone, and punctuation. Preferred:+ Bachelors Degree in Accounting,
Communications, Business or, Marketing About United Health
ServicesUnited Health Services is a not-for-profit healthcare
system serving more than 500,000 people in Upstate New Yorks
Southern Tier region. We offer integrated healthcare services
across 60 locations, including four hospitals, three walk-in
centers, and 22 primary care offices, in addition to home care
services and senior living facilities. The United Health Services
system employs more than 6,300 people and comprises 600+ providers
who are all committed to providing and supporting the delivery of
exceptional patient care.United Health Services employees and
providers are LOVED! This means were Living Our Values Every Day.
Here, youll join a team that is dedicated to values-based,
coordinated patient care. Every day, we outwardly live our Values
of Compassion, Trust, Respect, Teamwork, and Innovation. About New
Yorks Southern TierAs an employee of United Health Services, youll
call the Southern Tier, or more specifically, the Greater
Binghamton area, home. Known for entertainment and restaurants,
craft brews, outdoor experiences, minor-league sports,
family-friendly events, and a keenness for local history (like our
connection to the Twilight Zone and our six antique carousels),
Greater Binghamton offers something for everyone. Were a short
drive away from the Finger Lakes region in Central New York, three
hours from New York City, and just shy of four hours from Niagara
Falls, Canada. ----United Health Services in an Equal Opportunity
Employer.United Health Services, Inc. and the members of the UHS
System neither are affiliated with, sponsored, endorsed nor
approved by, nor otherwise associated with, Universal Health
Services, Inc. (NYSE: UHS), UHS of Delaware, Inc. nor their
affiliates, which can be found at www.uhsinc.com.
Keywords: United Health Services, Binghamton , Denials Recovery Specialist, Other , Binghamton, New York
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