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Job Description
Structured overview of role & requirementsAbout This Role
Investigate and resolve complex claim denials through analysis and direct payer engagement.
Lead and coordinate payer calls for escalated denial inquiries and disputes to improve reimbursement outcomes.
Develop and execute strategies to reduce denial rates, including mentoring junior associates and collaborating cross-functionally.
Minimum Requirements
Associate degree in healthcare administration or related field preferred (mandatory status not explicitly mentioned).
Proficiency in medical billing software and denial tracking systems.
Work Experience Required: Not explicitly mentioned in the JD.
Strong problem-solving, analytical, and communication skills necessary to negotiate claim resolutions.
Ideal Candidate Profile
Experienced in advanced accounts receivable and denial management techniques, capable of leading escalation and appeals processes.
Able to work independently and lead cross-functional collaborations to address root causes of denials.
Demonstrates leadership qualities suitable for mentoring junior associates and managing complex denial resolution workflows.