Collections & Denials Management Representative at Rochester Regional Health in Canton, New York

Job Description:

Description



SUMMARY:



Denials Management

The C & D specialist is responsible for reviewing accounts which have been denied or underpaid by third party payers and to resolve the issues resulting in denial/underpayment and to formally appeal. The specialist will conduct comprehensive reviews of clinical documentation to determine if an appeal is warranted. Should an appeal be necessary, the specialist will write compelling and factual arguments which will then be sent to the insurance carrier. The specialist will work across departments to gather the appropriate documentation and information for a clear and concise appeal.



Collections Management

Responsibilities will include basic knowledge of medical billing, medical claims processing and accounts receivable collections. The Medical collection specialist must have the Ability to learn and understand medical billing protocol and reimbursement issues, work within Meditech and Emdeon to identify denial trends as well as be responsible for locating and monitoring overdue third party accounts preventing write off. Must be comfortable working tight deadlines, have the ability to analyze and trouble shoot billing concerns and communicate concerns with management.



PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.



PAY RANGE: $19.86 - $28.82

The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran