Denial Management Representative - Remote

### 1. About Our Client:The organization operates within the healthcare revenue cycle management sector. It addresses the challenges of managing patient accounts from creation through payment, ensuring efficient resolution of insurance claims and disputed balances. The company supports effective revenue cycle processes by facilitating collaboration and adaptability within its teams, contributing to timely account management.### 2. About the Opportunity:The **Denial Management Representative** is responsible for resolving patient accounts by managing claim submissions, remittance reviews, and pursuing disputed balances with government and non-government payors. This role ensures timely resolution of accounts, supports team productivity, and helps maintain compliance with relevant regulations. The position contributes to the organization''s financial performance by addressing payment delays and optimizing collections.### 3. Responsibilities:• Research and manage uncollected account balances using patient accounting systems and online resources.• Contact third-party payors and patients via phone, email, or online to resolve account issues.• Update insurance and demographic information, document account notes, and identify payor trends.• Request and review additional documentation as needed for claims.• Review contracts for billing or coding issues and request necessary re-bills or corrections.• Open dispute records for accounts requiring further research.• Maintain desk inventory and meet productivity and quality standards.• Assist with special projects and communicate findings.• Identify and respond to payor delays to prevent aging accounts.• Escalate problematic accounts to supervisor when necessary.• Participate in meetings and training to enhance job knowledge.• Respond promptly to emails and phone messages.• Ensure compliance with state and federal regulations for managed care and third-party payors.### 4. Requirements:• Understanding of the revenue cycle process from patient access through billing and collections.• Intermediate proficiency in Microsoft Word and Excel.• Ability to quickly learn hospital systems such as ACE, VI Web, IMaCS, and OnDemand.• Clear and professional communication skills, both oral and written.• Strong interpersonal, analytical, and critical thinking skills.• Ability to make sound decisions and manage priorities effectively.• Knowledge of Commercial, Managed Care, Medicare, and Medicaid collections.• Familiarity with managed care contracts, contract language, and federal and state payor requirements.• Understanding of terms like HMO, PPO, IPA, Capitation, and processing of claims.• Intermediate knowledge of Explanation of Benefits (EOB) and hospital billing forms (UB04 and HCFA 1500).• High school diploma or equivalent; some college coursework in business or accounting preferred.• 1-4 years of medical claims or hospital collections experience.• Typing speed of at least 45 words per minute.### 5. Pay Range and Compensation Package:• The pay range and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors.### Equal Opportunity Statement:Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.Note:RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.