Denial Specialist

Job Description Summary

The denial specialist will analyze and research claim authorization denials and determine the appropriate course of action including but not limited to filing appeals and or filing adjustments. Document and monitor the status of appeal claims and follow up with payor representatives as needed to expedite resolution. Identify denial trends, root causes and make recommendations for process improvement. Ensure legal compliance by following company policies, procedures, guidelines, and as well as federal insurance regulations.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC005031 SYS - Revenue Cycle Middleware

Pay Rate Type

Hourly

Pay Grade

Health-20

Scheduled Weekly Hours

40

Work Shift

Job Description

The denial specialist will analyze and research claim authorization denials and determine the appropriate course of action including but not limited to filing appeals and or filing adjustments. Document and monitor the status of appeal claims and follow up with payor representatives as needed to expedite resolution. Identify denial trends, root causes and make recommendations for process improvement. Ensure legal compliance by following company policies, procedures, guidelines, and as well as federal insurance regulations.

Additional Job Description

High School Diploma Required

1-3 years experience in healthcare billing and insurance follow-up.

Experience in claim appeals and appeal follow up

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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