Denials Specialist - Remote

Overview

The Denials Specialist at Ensemble Health Partners is responsible for managing clinically related claim denials, ensuring efficient resolution and communication with insurance plans.

In Short

• Analyze claims, remittances, and denial letters.
• Contact insurance plans to determine reasons for claim denials.
• Prepare appeal materials and resubmit claims as necessary.
• Gather additional medical documentation as needed.
• Act as a liaison between healthcare providers for documentation clarification.
• Meet quality and productivity standards in processing appeals.
• Utilize knowledge of revenue cycle terminology.
• Collaborate with team members to improve processes.
• Participate in ongoing professional development.
• Work in a supportive and innovative company culture.

Requirements

• 1 to 3 years of experience in denials or accounts receivable.
• Associate’s degree or equivalent experience.
• Ability to type 35 wpm.
• Experience in hospital operations and provider relations.
• Strong analytical and problem-solving skills.
• Effective communication and interpersonal skills.
• Detail-oriented with a focus on accuracy.
• Familiarity with medical records and documentation requirements.
• Commitment to customer service excellence.
• Willingness to embrace new ideas and technologies.

Benefits

• Comprehensive benefits package including healthcare and retirement.
• Bonus incentives and paid certifications.
• Tuition reimbursement for professional development.
• Career advancement opportunities within the company.
• Recognition programs for outstanding performance.
• Supportive and collaborative work environment.
• Flexibility in work-life balance.
• Inclusive culture that values diversity.
• Access to well-being programs for employees.
• Opportunity to work for a recognized top workplace.