Denials Analyst
Contract to Hire
Dublin, CA
$52-$65 per hour DOE
Join a well-established and highly-efficient team in Healthcare!!
Option 1 Staffing is seeking a detail oriented individual with extensive experience in commercial insurance and government systems to mitigate financial risk caused by denial of payments.
Key Responsibilities:
- Collaborate with Revenue Cycle personnel, case managers and physicians to appeal clinical and technical denials
- Review, coordinate and monitor the clinical denials and appeals process
- Collaborate with management to develop successful appeal strategies
- Create letter templates, reference and educational materials for staff regarding regulatory standards relating to denials
- Facilitate reimbursement through appeal writing
- Provide training for staff as a clinical subject matter expert for clinical denials and provide feedback for process and workflow changes
Qualifications:
- Bachelor of Science preferred
- Seven years clinical/patient care experience
- Prior authorization process for all providers, ordering and rendering
- Excellent communication skills
- Five years in utilization review using tools such as Millimann, Interqual, etc
- Demonstrates a strong understanding of government and commercial insurance programs and state and federal regulations
If you are an experienced Denials Specialist, confident in your knowledge of state and federal regulations and excellent communication skills, we want to speak to you!
Option 1 Staffing is an award-winning, recognized leader in staffing and recruiting. We specialize in placing the highest caliber of Non-Clinical Healthcare, Information Technology, Supply Chain, Administrative, and Accounting/Finance professionals in contract and direct-hire opportunities across the nation.
