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Payment/Denial Management Specialist

Posted: July 30, 2024
Salary:US$20 - US$23 per hour
Location:Manhattan
Job type: Permanent
Discipline:Revenue Cycle
Reference:231698_1722354704
Work Location:On-site

Job description

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!