Researches and analyzes denials on a daily basis, identifies root causes, and processes resubmissions/appeals with the goal of overturning the denial and getting paid by the insurance carrier, maximizing revenue for the division.
Three to five years of progressive experience in appeal/denial management- Preferred
Strong knowledge of health plan requirements
Strong analytical, statistical analysis skills required. Strong knowledge of EPIC, Microsoft Excel, Word and Power Point skills required
Knowledge of federal, regional and state payer coverage patterns (CMS, fiscal intermediary, and Administrative
Strong organizational and communication skills; professionalism, able to work with all levels of staff.
Bachelor's Degree preferred ( Certified Professional Coder(CPC )
Associate's Degree required (Medical Billing experience)
Certified Professional Coder (CPC) required
EPIC Cadence, HB, PB certifications preferred
Knowledge of CPT coding and ICD10 diagnosis required
Ability to work and effectively multi-task in a fast-paced clinic environment with patients with developmental disabilities.
Department: Pediatrics Bargaining Unit: Non Union Campus: MOSES Employment Status: Regular Full-Time Address: 1225 Morris Park Avenue, Bronx
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 225542 Salary Range/Pay Rate: $62,400.00 - $78,000.00
For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.
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Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.
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