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Denials Management Specialist
Baptist Health - Central AlabamaDenials Management Specialist responsible for validating disputes and generating appeals for denied claims at Baptist Health. Resolve aged accounts by analyzing regulations, contracts, and documentation.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in billing and collections within a hospital or medical office environment, with a strong focus on regulatory compliance and coding standards. Proficient in analyzing payment variances and generating appeals for denied claims.
Highest-signal resume keywords
Billing And Collections ExperienceICD-9, ICD-10, And CPT Coding KnowledgeCRCR Or CPAR CertificationStrong Analytical And Problem-Solving AbilityMS Office Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
BillingCollectionsRegulatory ResearchPayment Variance AnalysisAppeals GenerationDocumentationCoding Standards
Soft Skills
Problem-SolvingAnalytical Thinking
Tools & Technologies
MS OfficeBilling Software
Certifications & Qualifications
CRCRCPAR
Industry Keywords
Hospital BusinessMedical OfficeManaged CareRevenue IntegrityCollection Activities
About the role
Key responsibilities & impact- Validate dispute reasons and escalate payment variance trends to management.
- Generate appeals for denied or underpaid claims.
- Resolve complex and aged accounts through research of regulations and billing rules.
- Provide feedback to Managed Care and Revenue Integrity teams.
- Document all pertinent collection activities thoroughly.
Requirements
What you’ll need- High School diploma or equivalent required.
- Associates degree or higher preferred.
- Minimum of at least 3 years’ experience in a hospital business or medical office environment performing billing and/or collections.
- CRCR or CPAR certification preferred.
- Excellent knowledge of MS Office and familiarity with relevant computer software.
- Strong analytical and problem-solving ability.
- Knowledge of ICD-9, ICD-10, and CPT coding.
Benefits
Comp & perks- Health insurance
- Paid time off
- Professional development opportunities