Payment/Denial Management Specialist

Medix is hiring a Payment and Denial Management Specialist to support a speciality prosthetics organization in Manhattan, NY. This is a highly reputable organization that is affiliated with most major hospital systems! They are looking for dedicated and motivated individuals looking to grow within the organization.

Responsibilities:

• Post all payments including check, EFT's, Recoups and credit card/cash payments

• Post all hospital payments

• Accurately post TPA payments with fee deductions

• Accurately posts recoups from carriers and applies forward negative balance to appropriate accounts

• Investigates insurance carrier overpayments and recoups

• Process patient and insurance carrier refunds and submit to AP

• Answer patient phone calls related to account balances, refunds and billing inquiries

• Escalate patient phone calls when necessary

• Review EOP's when posting manual checks, autoposting EFT's and $0 payments

• Review any balances for patient deductible, coinsurance or secondary carrier and setting correct financial responsibility

• Submit secondary carrier electronic billing claims

• Daily Review of the posting log to monitor payments and post within 3 business days of deposit

• Ensures payment reconciliation/balancing when posting manually/auto-post

• Review posting log for up-to-date reconciliation

• Review payor codes are updated in PMS when posting

• Report any fee schedule discrepancies to management

• Denial Management- Review EOB's for line item denials

• Submit front office discrepancy denials

• Submit corrected claims (modifier issue, demo discrepancy, incorrect POS, NPI) to all carriers and noting the PMS detailing corrections made

Qualifications:

• 2 years of Experience Preferred
• Knowledge of NY Medicaid and CT Medicaid
• Knowledge of A/R/Billing
• Experience with Data Entry/Payment Posting

Schedule:

Monday-Friday, 8:30am to 5:30pm

Interviews are taking place now - apply today!