Sr Appeals/Denials Specialist
 TEKsystems | |
$22.00 - $26.00 / hr
| |
 United States, Texas, Addison | |
 Nov 22, 2024 | |
|
*Description:*
- Review and analyze denied claims, payment discrepancies, and reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and accurate submissions. - Prepare compelling appeal letters, supporting documentation, and necessary forms to present a strong case for claim reconsideration. - Stay up-to-date with payer policies, regulations, and industry trends related to claim appeals and arbitration. - Maintain a comprehensive understanding of coding guidelines, medical necessity, and reimbursement methodologies to strengthen appeal arguments. *Additional Skills & Qualifications:* - Proven experience as an Appeals and or denials Specialist or in a similar role within a healthcare setting. - In-depth knowledge of healthcare revenue cycle processes, claim adjudication, and reimbursement methodologies. - Familiarity with insurance denials, appeals, and arbitration processes, including knowledge of payer-specific appeal requirements and guidelines. - Strong understanding of medical coding (CPT, HCPCS, ICD-10) and medical terminology. FULLY ONSITE in ADDISON** 1st shift hours About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. | |