Denial Reimburse Specialist

Some people love getting to the bottom of things -- chasing down denied claims, resolving accounts, digging through the details to identify discrepancies and needs. Yes, we’re talking about people who love collections. And it takes a love of getting into the details to do this job well.

WHO WE ARE

Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve.

WHAT YOU CAN EXPECT

• Conduct inquiries via phone, mail, fax, or electronically to conduct follow-up on the accounts that have been denied and resubmitted for payment.

• Conduct follow-up with insurance carriers, physicians, and other stakeholders that can validate and assist with actions and information needed to properly review, dispute or appeal denial until a determination is made to conclude the appeal.

• Ensure information sent to insurance carriers has all release of information necessary and is HIPPA compliant.

• Analyze reports and use software to track, trend and identify root causes of denials; offer suggestions for process improvement to resolve denial issues, supported by documentation and data.

• Review denials and payment discrepancies identified through the denial system, which are directly related to the verification, authorization and registration process.

• Prepare and submit patient record requests from care delivery sites and provide correspondence to patient on requested information.

QUALIFICATIONS

• Required High School Diploma/GED
• 2 years Revenue Cycle with strong AR account follow-up, appeals, billing and/or coding knowledge OR Insurance Verification/Patient Accounting Required

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.