Denial Specialist, Part Time, Remote

Overview

The HIM Denials Specialist is responsible for managing claim denials, to include thoroughly reviewing the denial and supporting documentation (ie: Medical record, denial rationale, and appeal rationale) If warranted, the Denials Specialist will ensure that an appeal letter, is well written and submitted in a timely manner. The HIM Denials Specialist will also be responsible for maintaining the Denials database, perform follow-up, and process appeals timely.

The HIM Denials Specialist has full access to patient health information.

HIM Denials Specialist will work on-site.
Shift: Flex remote, 24 hrs. per week

• High School Diploma or equivalent required. Associate degree in related field preferred.
• Current AHIMA or AAPC credential (RHIA / RHIT / CCS / CCA / CPC / CPC-H) preferred.
• Enrollment in accredited Health Information Management and/or medical coding program accepted.
• At least 1 year of work experience in insurance, customer service, healthcare, or related field is preferred.
• Excellent communication, computer and typing skills required.
• Ability to tolerate viewing computer monitors for extended periods of time.
• Familiarity of medical terminology, anatomy, physiology, and various medical specialties preferred.
• Familiarity of ICD-10 CM, ICD-10 PCS, CPT, and MS-DRG preferred.
• Familiarity of insurance regulations, denial codes, and denial rationale preferred.
• Detail oriented, and able to work with increasing independence.
• Ability to handle difficult interactions with resilience and professionalism.
• Able to identify problematic situations / issues and work with management to resolve or improve them.

• Must pass a basic FIT test to include bending, stooping, standing, and sitting for extended periods of time.
• Must be able to lift and carry up to 30 pounds.
• Requires eye-hand coordination and manual dexterity.
• Requires normal vision/hearing range (+/- assistive devices such as glasses or hearing aids).