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Denials Resolution Specialist II


PayCompetitive
LocationWorcester/Massachusetts
Employment typeFull-Time

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  • Job Description

      Req#: R24115647
      Employer Industry: Healthcare

      Why consider this job opportunity:
      - Potential signing bonus available
      - Opportunity for career advancement and growth within the organization
      - Work Monday through Friday from 8 AM to 4 PM
      - Collaborative and supportive work environment
      - Chance to contribute to exceptional patient care and community support
      - Engage in a diverse workplace that values respect and inclusion

      What to Expect (Job Responsibilities):
      - Triage denial root causes and execute appropriate next steps for resolution
      - Identify trends and participate in interdepartmental strategies to reduce future denials
      - Train staff on payer websites and provide guidance on navigation
      - Resolve accounts with high dollar balances, ensuring rapid resolution
      - Document all actions taken during the denial resolution process clearly

      What is Required (Qualifications):
      - A minimum of a High School diploma
      - Four or more years of experience in healthcare billing functions
      - Proven track record of successful performance and goal achievement
      - Advanced knowledge of claim form content and submission requirements
      - Ability to communicate clearly and document actions taken during the resolution process

      How to Stand Out (Preferred Qualifications):
      - Experience with high dollar and high complexity claim submissions
      - Ability to navigate MassHealth and Medicare claims processing applications
      - Strong interpersonal skills and ability to work collaboratively with others

      #Healthcare #PatientCare #Billing #CareerGrowth #DiversityInWorkplace

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

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