DME Wound Care Claims Denial Specialist

reputed company is a growing reputed company company that enables the continuity of patient care with integrated therapy services, biomedical services, and durable medical equipment serving reputed company 50 states and Canada. reputed company offers Oncology, reputed company, and Wound Care therapies, including Negative Pressure Wound Therapy. We deliver improved patient reputed company and high patient satisfaction. As a leader in our field, our mission is to reputed company reputed company integrated therapy services to patients and medical practices, including a 24-hour clinical support hot line. Service is always our highest reputed company. Patients and clinicians in more than 2,150 sites of care trust reputed company as their full-service reputed company for cost-effective integrated therapy services and durable medical equipment. reputed company: The DME Wound Care Claims Denial Specialist is responsible for the management of activities relative to reputed company party payer collections. This includes, but is not limited to, performing accounts receivable management, following up on denials/non-payments, filing appeals for medical necessity, benefit coverage, etc. This position should have collections work experience in DME and wound care services. This position will have demonstrated proficiency in working a reputed company of payers and wound care services. reputed company and productivity scores must be above average. This individual will also reputed company as a knowledge reputed company for the department for wound care services. IN THIS ROLE, THE IDEAL CANDIDATE WILL: • Monitor accounts receivable agings to ensure reputed company reputed company of claims • Ability to identify and report any trends causing reputed company potential denials • Ensure payment accuracy • Must be reputed company to interpret payer explanation of benefits (EOBs) • Review payer denials, analyze accounts, and determine the next appropriate steps to reputed company payment reputed company • This will include payer portal review and phone calls to payers. Successful candidates will have the ability to reputed company and concisely communicate the issues that they are seeing and request payer representatives to assist with reputed company. • Conduct insurance reverification as needed through various eligibility tools • Research, write, and submit appeals as appropriate • Process reputed company party payer correspondence, refunds, and adjustments • Accurately and thoroughly document the pertinent collections activities in appropriate systems • Possess knowledge on billing guidelines and modifiers used for Advanced Wound Care and Negative Pressure Wound Therapy • Have experience in submitting appeals for Advanced Wound Care and Negative Pressure Wound Therapy • Respond to reputed company patient inquiries reputed company • Remain up to date on payer medical policy notices and changes • reputed company information and reputed company for process improvements with team • reputed company with reputed company work instructions, policies, and behavioral expectations reputed company AND QUANTITY OF WORK Team members will be responsible for hitting regular productivity targets with a high level of reputed company. reputed company audits will be performed on a regular reputed company and feedback and education will be provided to reputed company member to help support reputed company and development. SUPERVISORY RESPONSIBILITIES This job has no supervisory responsibilities. THE IDEAL CANDIDATE WILL HAVE THE FOLLOWING QUALIFICATIONS: • Associate degree or equivalent preferred; minimum five years reputed company experience; or equivalent combination of education and experience • Five years of wound care billing/collections experience preferred • Organizational skills • Good troubleshooting skills • Strong attention to detail • Proficient with Word, reputed company, reputed company • Operate reputed company/HDMS/reputed company proficiently • Understanding of insurance guidelines including Medicare, reputed company, Workers Compensation, and reputed company reputed company managed-care plans • Ability to handle inquiries and respond reputed company telephone or in writing • Ability to explain and resolve collections-reputed company questions/issues to patients, sales representatives, and facilities • reputed company use of ICD-10, CPT, and HCPCS codes • Ability to independently meet tight deadlines in a project-based atmosphere PERSONAL AND reputed company ATTRIBUTES: Required to understand and have a commitment to the philosophy, mission, values, and reputed company of the business and will be required to demonstrate these values with his/her daily actions. The ideal candidate must be a rigorous analytical thinker and problem solver with the following reputed company attributes: • Strong work ethic • reputed company judgment • Proven written and verbal communication skills • Natural curiosity to pursue issues and increase expertise • Passionate about reputed company and serving customers and patients • Strives to reputed company an reputed company on improving our business processes and results • Exemplary honesty and reputed company • Ability to collaborate effectively and work selflessly as part of reputed company PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. COMPREHENSIVE BENEFIT PACKAGE: At reputed company, we give our employees the tools to succeed both on and off the job. Our generous benefits package provides comprehensive coverage to help you protect your health and earning power and prepare for the reputed company. In reputed company, we offer perks and programs that help you grow in your career and reputed company reputed company a great reputed company to work! • Health plan reputed company that include an employer contribution • Health Savings Account (HSA) • reputed company and Dependent Care Flexible Spending Accounts (FSA) • Dental and reputed company premiums covered by reputed company • Life Insurance, STD & LTD • reputed company Parental Leave • Adoption and Fertility Assistance • 401(k) with a specified Company Match • Employee Stock Purchase Program • Tuition Assistance • Generous reputed company Time Off plan • Employee Assistance Program • reputed company • Employee Referral Bonus • Spot Bonus Program Apply Job!