RemX has an exciting opportunity for a Denials Analyst in Rancho Mirage, CA!  This is for a large Healthcare Organization! 

Schedule:

• Monday - Friday 8am - 5pm 

Duration: 

• 13 weeks w/ potential for 3 months extension 

Job Responsibilities: 

• Responsible for researching and resolving claim denials, ADR requests and certs, submitting and tracking appeals, noting trends and providing monthly reports.
• Responds to audit requests (including RAC) from payors.
• Maintains a Library of Payer reference material regarding requirement for pre authorization, medical necessity and documentation requirements.
• Works with the Revenue Cycle stakeholders (e.g. Admitting, Coding, Provider Liaisons, etc.) to provide information related to denials and opportunities for future denials.

Qualifications

Education

• Required: High School diploma or equivalent

Licensure/Certification

• Preferred: Certified coder or currently enrolled in a coding program

Skills:

• Strong Analytical skills, Proficient in Microsoft Windows with emphasis on Excel.
• Ability to prioritize and coordinate workflow and attention to detail.
• Knowledge of CPT, HCPC and ICD 10 coding requirements with emphasis on modifiers and diagnosis association.
• Working knowledge of LCDs, NCCI and MUE edits as well as a general knowledge of Commercial, HMO, and Medicare Advantage claims, authorization and documentation requirements.