Denials Analyst

Seeking an onsite Denials Analyst in Houston, Texas!

Overview:
Analyzes health care insurance/litigation patient account files and contacting insurance companies and patients to resolve any and all outstanding and delinquent insurance payments due to the health care client.

Job Duties:

• Review the Denial listed on the account and determine if it is correct by reviewing all necessary documentation in all systems available (TCS, Availity and Client System) and determine if the assigned denial is correct and identify next steps.
• Document findings and next steps in TCS.
• Preform next steps required to move the account forward in the collection process.
• Complete all required fields in TCS needed for projects and mediation reviews.
• Is required to submit reconsiderations to a payor with all appropriate supporting documentation.
• Is required to analyze clinical data provided by the client to write a clinical appeal letter.
• Identifies repetitive denial reasons and submits information to leadership for a potential grouper. Collector will still attempt to collect on these accounts while waiting on further direction from the Attorney.
• Provide support for team members that me be out or backlogged willingly.
• Participates in meetings, training sessions, seminars and in-services in a positive and professional manner.

Qualifications:
1. 3-5+ years of denials experience
2. Insurance collections experience
3. Previous healthcare/revenue cycle knowledge
3. High school diploma