Denials Analyst

Denials AnalystContract to HireDublin, CA$52-$65 per hour DOEJoin a well-established and highly-efficient team in Healthcare!!Option 1 Staffing is seeking a detail oriented individual with extensive experience in commercial insurance and government systems to mitigate financial risk caused by denial of payments.Key Responsibilities:Collaborate with Revenue Cycle personnel, case managers and physicians to appeal clinical and technical denialsReview, coordinate and monitor the clinical denials and appeals processCollaborate with management to develop successful appeal strategiesCreate letter templates, reference and educational materials for staff regarding regulatory standards relating to denialsFacilitate reimbursement through appeal writingProvide training for staff as a clinical subject matter expert for clinical denials and provide feedback for process and workflow changesQualifications:Bachelor of Science preferredSeven years clinical/patient care experiencePrior authorization process for all providers, ordering and renderingExcellent communication skillsFive years in utilization review using tools such as Millimann, Interqual, etcDemonstrates a strong understanding of government and commercial insurance programs and state and federal regulationsIf you are an experienced Denials Specialist, confident in your knowledge of state and federal regulations and excellent communication skills, we want to speak to you!Option 1 Staffing is an award-winning, recognized leader in staffing and recruiting. We specialize in placing the highest caliber of Non-Clinical Healthcare, Information Technology, Supply Chain, Administrative, and Accounting/Finance professionals in contract and direct-hire opportunities across the nation.