Central Florida Health Job - 43970205 | CareerArc
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Company: Central Florida Health
Location: Leesburg, FL
Career Level: Associate
Industries: Healthcare, Pharmaceutical, Biotech

Description

The PFS Insurance Denials Representative is an experienced professional with extensive experience and in-depth knowledge in insurance claims processing and in all areas of financial reimbursement. Required to research and investigate account status, claim processing, payment delays, ensure accurate adjustments are applied, and identify payment variances. The PFS Insurance Denials Rep is responsible for the accurate and timely processing of accounts assigned to them for denials resolution. This role involves the review and evaluation of claim denials and to ensure aggressive and consistent denial resolution activity from beginning to closure. They are responsible for the accurate and timely processing of accounts assigned to them for denials resolution.

Education

  • Post High School Special Training-Preferred.
  • High School Diploma/GED-Required.

 

Licensure/Certification/Registration

Special Skills/Qualifications/Additional Training/Experience Required

  • Minimum 3-4 years of experience in hospital billing, insurance collections, or other healthcare revenue cycle position and denials experience in the hospital setting.
  • Working knowledge of CMS UB/1500 electronic claim form completion.
  • Knowledge of follow-up and payment recovery techniques.
  • Familiarity with medical terminology and basic coding principles.
  • Strong analytical, verbal and written communication skills.
  • Ability to make mathematical calculations and compose professional correspondence.
  • Basic computer, internet, e-mail, and spread sheet competencies required.
  • Understand technical system aspects of claims processing.
  • Must be able to interpret and understand payer reimbursement policies, regulations, and administrative rules.
  • Must be able to read, write, speak and understand English.


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