Job Description

Analyze Denied Claims

: Review and investigate denied insurance claims to understand the reasons for denial, including issues related to coding, documentation, and compliance with payer policies.

Correct and Resubmit Claims

: Make necessary corrections to claims and resubmit them to insurance companies for payment. This may involve gathering additional documentation or clarifying information to support the claim.

Write Appeals

: Prepare and submit written appeals for denied claims, using well-researched arguments based on clinical documentation, payer policies, and contract language.

Maintain Accurate Records

: Keep detailed records of all actions taken on denied claims, including communications with insurance companies and the outcomes of appeals.

Identify Trends

: Monitor and analyze denial patterns to identify recurring issues, and report findings to management for process improvement.

Collaborate with Healthcare Professionals

: Work closely with medical coders, billing staff, and healthcare providers to ensure that claims are submitted correctly and to address any issues that arise.

Skills Required

Analytical Skills

: Ability to analyze complex information and identify solutions to resolve claim denials effectively.

Attention to Detail

: Strong organizational skills to manage a high volume of claims and ensure accuracy in documentation and submissions.

Communication Skills

: Excellent verbal and written communication skills to interact with various stakeholders, including insurance providers and healthcare professionals. The role of a Denials Specialist is crucial in the healthcare industry, as it directly impacts the financial health of healthcare organizations by ensuring that claims are processed efficiently and accurately.
Job Type: Full-time

Pay: ?35,000.00 - ?45,000.00 per month

Benefits:

Health insurance Provident Fund
Work Location: In person

Speak with the employer

+91 08754404496
Expected Start Date: 01/08/2025