You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

The Patient Financial Services Denial Specialist is responsible for reviewing denied claims and carrying out the appeals process. This position works to maintain third-party payer relationships, including responding to inquiries, complaints, and other correspondence, and possibly setting up arbitration between parties.  The denial analyst has a working knowledge of state/federal laws that relate to contacts and to the appeals process.  Maintains and monitors integrity of the claim development and submission process. 

This position is remote after an initial onsite training period at either the Burr Ridge or Harvey locations.

Overview of Responsibilities:

• Executes the denial appeals process, which includes receiving, assessing, documenting, tracking, responding to and/or resolving appeals with third-party payers in a timely manner.  Regularly makes complex decisions within the scope of the position, and is comfortable working independently
• Works closely with insurance and managed care companies to ensure proper review and processing of denied claims
• Acts as a liaison between insurance companies and physicians to provide medical necessity for denied claims
• Identifies and tracks payer denials trends and works with the payers to correct any erroneous denials and works with the departments to review and improve processes to avoid these denials in the future
• Conducts relevant research to assist with completing the appeals process and to stay informed on best practices and policy reforms
• Maintains data on the types of claims denied and root causes of denials, and collaborates with team members to make recommendations for improvements and resolving issues
• Contacts patients to communicate insurance coverage denials and works with the patient to overturn the denials related to patient information needed
• Works closely with the Denial Manager to provide key information for the Denial Task Force Meetings.  Complies with State and Federal regulations, accreditation/compliance requirements, and policies, including those regarding fraud and abuse, confidentiality, and HIPAA.  Maintains current knowledge of rules and regulations of third party payers.  Performs related duties as required

Qualifications:

• 3-5 years of Revenue Cycle Management experience including Insurance Denials & Appeals
• Hospital claims / UB04 experience (highly preferred)
• EPIC (highly preferred) 

Additional Skills:

• Strong written and verbal communication skills
• Team Player who can also work independently

Schedule: Monday-Friday 7am-3:30pm (some flexibility with start time - latest start time is 8:30am)

Equipment Deposit Program: A $50 deposit will be withheld from each paycheck for the first 10 weeks of employment for a total of $500 equipment security deposit. The full amount will be returned to you upon return of the equipment, or upon permanent employment.

Pay: $24-32 per hour depending on experience 

Length: 800 Hours (approx. 5 months) Contract to Hire*

*Possibility of long-term employment upon successful completion of contract period

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.