|Responsible for resolution of all third party payer rejections. Must be able to determine root cause of rejections and determine necessary ?next steps? required to resolve error. Must be familiar with follow up processes such as claim correction, appeal processes for third-party payers, electronic claim resubmission processes and calling payers to resolve to investigate denials. Must be able to effectively communicate with other departments such as Coding, Patient Accounting, and Customer Service as needed to resolve issues with accounts.|
Talent Pool: Corporate Services/Professional
|Required: Associate's Degree and Coding Certification |
Preferred: RHIT or RHIA
Must be able to efficiently navigate billing system, payer website and any vendor software used in denial management.
Required: Coding Certification - must be maintained.