Job Description
Our client is seeking a sharp, analytical, and results-driven Technical Denials & Appeals Specialist to join their team. If you have a proven track record of diving deep into physician billing claims, uncovering why they were rejected, and actually writing the winning appeals that overturn them, we want to talk to you.
This is a remote opportunity. However, candidates MUST RESIDE WITHIN the GREATER DFW AREA to facilitate equipment pickup, attend in-office meetings, and participate in on-site training as required.
salary: $20 - $22 per hour
shift: First
work hours: 8 AM - 4 PM
education: High School
Responsibilities
- Denial Analysis: Analyze payer denials by denial groupers and submit comprehensive appeals to secure reimbursement.
- Physician Billing & Appeals: Manage the full-cycle physician billing process, identifying root causes of technical and clinical denials to draft and submit high-impact appeals that maximize revenue recovery.
- Claim Resolution: Contact patients and third-party payers to resolve outstanding insurance balances and underpaid claims.
- Payer Navigation: Review Explanations of Benefits (EOBs) to determine claim processing logic and contact carriers for status updates on claims, appeals, and insurance verification.
- Financial Adjustments: Process necessary financial adjustments as required by specific plan reimbursement guidelines.
- Interdepartmental Liaison: Serve as a key point of contact between clinical departments and the management team.
- Trend Identification: Monitor and report on payer trends involving Managed Care, Commercial, Medicare, and Medicaid.
Skills
- Medical Billing - Denials
- Verbal Communication
- Analytical Thinking
- Denial Management
- Revenue Cycle (1 year of experience is required)
- HIPAA
- Medicare/Medicaid
- Physicians Billing (2 years of experience is required)
- appeals (2 years of experience is required)
Qualifications
- Years of experience: 3 years
- Experience level: Experienced
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
Job Tags
Hourly pay, Permanent employment, Temporary work, Work experience placement, Work at office, Remote work, Shift work