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Worker's Compensation Denial Specialist
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Full-time
- Job DescriptionJob DescriptionPremier Medical Resources is seeking to hire a Workers Compensation Denial Specialist is responsible for performing insurance appeals of denied and underpaid accounts.
- ESSENTIAL FUNCTIONS: Responsible for managing, monitoring, and collecting payments on accounts from all WC Third-Party Payers Reporting of denial trends and payer policy updates to management.
- Work with Supervisor/Manager to identify denial/payment trends and create solutions to decrease future denials Maintain understanding of payer contracts, claims filing deadlines and fee schedules Works with WC insurance providers to resolve and appeal any denied or underpaid claims.
- Assist in creation of standard appeal templates Performs ongoing trend analysis on third party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts.
- Knowledgeable in all medical Commercial and Government insurance plans Knowledge of medical terminology, CPT codes, ICD-10 codes and procedures, technical job knowledge, and Third-Party payer requirements and reimbursement rules.
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