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Clinical Denials Specialist

Medical Collection | Dallas, TX | Contract

Job Description
Clinical Denials Specialist
Work Location: Dallas, TX

Job Summary/Description
Under the direction of the billing Operations Manager, the Clinical Denials Specialist is responsible for monitoring denials, appeals, and resolutions from participating insurance carriers and working proactively to collect from insurance carriers. Position work hours is Monday-Friday 8:00 am - 5:00 pm.

Job Duties/Responsibilities/Functions (including but not limited to)
• Collect and review denial information to formulate appeals, sending appeal correspondence and essential documentation to appropriate carrier.
• Perform patient account research to prevent billing rejections, work with various departments as needed.
• Analyze final claim denials to determine internal weakness in the organization and assist in developing action plans to avoid future denials.
• Develop reports/ feedback to be presented to Denials Management team and the monthly Committee Against Denials meeting.
• Assist as needed with chart audits, comparing the medical record against the patient's itemized bill to ensure complete and accurate charge capture.
• Complete special projects as identified and needed.
• Performs other duties as assigned.

Minimum Qualifications
• Two-year degree in related field required.
• Experience in a revenue cycle role that includes denial management, knowledge of coding, medical record documentation, Government billing requirements or five (5) years’ experience in hospital revenue cycle and claim appeals.
• Experience with medical appeals required.
• Licensure as Registered Nurse or LVN by State of Texas preferred.

About InGenesis
InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.

EEOC Statement
We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.