Patient Accounts - Denials Specialist - FT - 1st Shift Job Listing at Wilson Health in Sidney, OH (Job ID 8a7885ac9d02e54a019d1c1c52243ff0)

Description

Wilson Health is seeking a full-time, experienced Denial Specialist -  for our location in Sidney, Ohio.   Key Perks and Benefits:

• Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
• Generous paid time off (PTO) program beginning day one, designed to support work-life balance, rest, and time with family.
• Medical Insurance: Choose from two High Deductible Health Plan (HDHP) options or a PPO plan, along with Dental and Vision coverage. Benefits begin on the first of the month following your hire date.
• HSA with employer contribution for eligible health plans; FSA for medical and dependent care expenses.
• Company-paid Life Insurance and Long-Term Disability Insurance
• Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance Industry-leading retirement plan – employer contributions begin day one with no waiting period for participation.
• Tuition Assistance Program
• Free access to an on-site gym, available 24/7, making it easy to prioritize your health and wellness before or after your shift.

Employment Status: Full Time - HYBRID, after 6 months of training.              Position Reports To: Manager, Patient Accounting Working Hours: Monday – Friday, Flexible Working Hours, Begin as Early as 6:30 am. Option for either 8 or 9 hour work day.   Who We Are: At Wilson Health, our mission is to improve the health and wellness of our communities by delivering compassionate, quality care. We are committed to making a difference for our neighbors, friends, and family and our vision is to be a trusted, nationally recognized leader of innovative, collaborative community health.   POSITION SUMMARY: Under the direction of the Director and Supervisors of Patient Accounts, the Billing Specialist releases claims electronically and mails hard copy UB/1500 claims as required. The Billing Specialist will follow up on unpaid claims and rebill or appeal claims as indicated. Billing Specialist will review claims and ensure claims are not rejected or pending.   KEY DUTIES AND RESPONSIBILITIES:

• Experience with Electronical Health Records (EHR) -  EPIC preferred. Microsoft Office/Excel Experience preferred.
• Billing of claims through Electronic Vendor (Quadax) which requires keeping up to date with Payer requirements and/or edits.
• Prior experience with Medicaid and Medicare billing preferred.
• Keep up to date with Payer Policies, Requirements and/or Edits.
• Works closely with all departments throughout the hospital regarding charges and/or late charges.
• Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons.
• Appropriate follow up on denial/appeal/until payment received
• Works with Case Management and Medical Records regarding RAC audits, other audits, requesting medical records, and inpatient denials.
• Works mail as it applies to Denial Specialist to secure payment. Works closely with Central Scheduling/Registration, Case Management and Medical Records regarding Denials for No Authorizations and/or Medical Necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal.
• Other duties may be assigned. 

OTHER SKILLS and ABILITIES:

• Accurate typing skills, computer keyboard skills and data entry.
• Knowledge of medical terminology, CPT and HCPCS codes.
• Ability to work in a highly stressful environment.
• Ability to adapt to change.
• Organization and prioritizing skills.
• Ability to communicate with co-workers.

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The ability to communicate with a professional friendly personality to the customer is essential. Internet skills and the ability to navigate through different systems.

EDUCATION and/or EXPERIENCE: High school diploma or general education degree (GED) and minimum of one-year experience and/or training; or equivalent combination of education and experience. EPIC billing experience REQUIRED   Mission & Vision & Values:

• Improve the health and wellness of the community by delivering compassionate, quality care.
• Be a trusted, nationally recognized leader of innovative, collaborative, community health.
• A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence.

EOE (Equal Opportunity Employer)  

 Apply on company website