Apply on Employer Site

Presbyterian Healthcare Services · 1 day ago

Patient Accounting Denials Specialist II-ABQ

PMG - Pan American

Full-time

Onsite

Mid Level

$15.99/hr - $23.76/hr

3+ years exp

Presbyterian Healthcare Services is a not-for-profit healthcare system dedicated to improving the health of patients and communities. The Patient Accounting Denials Specialist II is responsible for root cause analysis of denials, performing A/R follow-up, appeals, and processing correspondence to resolve issues efficiently.

AssociationHealth Care

H1B Sponsor Likely

Responsibilities

Performs denial follow-up activities for assigned payors utilizing work queues

Submits corrected claims, reconsiderations and/or appeals to overturn denials

Responsible for providing any information (medical records, itemized statements, etc.) requested by insurance companies to process claims and overturn denials

Must follow process/procedures to ensure timely follow up on outstanding denials

Document accounts in accordance with established PHS policies/procedures

Knowledgeable in various computer systems (i.e. Electronic Health Record, claims clearinghouse, FISS/DDE, Payer portals, Microsoft Office Suite.)

Must utilize communication skills to be an effective team member

Must actively participate in team meetings and take a proactive approach to communicate work related ideas and concerns

Must develop and maintain professional work relationships with team members, PHS departments and outside agencies

Maintains strictest confidentiality, adheres to all HIPAA and CMS compliance rules and regulations

Perform other duties as assigned by the Denial Supervisor and/or Manager

Responsible for root cause analysis and next step resolution of denials

Performs denial follow-up activities for assigned payors utilizing work queues and various reports

Reviews incoming denials to identify trends and perform root cause analysis to determine resolution to be implemented to prevent ongoing denials

Consult with lead regarding next steps with difficult claims

Qualification

Insurance follow-upClaims processingMicrosoft Office SuiteRoot cause analysisCoordination of benefitsRevenue cycle processesCommunication skillsOrganizational skillsProblem-solving skillsAttention to detailTeamwork

Required

High school degree or GED required

short-term training on insurance collections and claims processing

Minimum three years experience in insurance follow-up, billing, and collections

Demonstrated ability to communicate effectively via telephone and in writing

computer literate

Experience with Microsoft Office Suite products required

Excellent organizational, problem-solving, verbal, and written communication skills

attention to detail

ability to interact effectively with other functional areas and management teams

strong work ethic

demonstrated ability to work effectively in a team environment

Must be able to prioritize and manage a high-volume workload

able to work in a fast-paced environment

contend with continually changing payer regulations and requirements

Preferred

Basic knowledge of Coordination of benefits and the Medicare MSPQ

Basic knowledge of various payer requirements

claim submission processes for major insurances carriers and intermediaries

Basic knowledge of the revenue cycle processes

Benefits

Medical

Dental

Vision

Short-term and long-term disability

Group term life insurance

Other optional voluntary benefits

Wellness challenges

Webinar

Preventive screening

Company

Presbyterian Healthcare Services

Glassdoor3.6

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities they serve.

Founded in 1908

Clovis, New Mexico, USA

10001+ employees

http://www.phs.org

H1B Sponsorship

Presbyterian Healthcare Services has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (90)

2024 (86)

2023 (85)

2022 (93)

2021 (86)

2020 (76)