Description
We are seeking a detail-oriented Multi-speciality Denials - QA professional to join our team. This role involves reviewing and analyzing denial cases across various specialties, ensuring compliance with billing and coding standards, and improving overall claim resolution processes.
Responsibilities
- Review and analyze denial cases to identify trends and root causes.
- Collaborate with the billing and coding teams to ensure accurate claim submissions.
- Prepare detailed reports on denial reasons and resolutions for management review.
- Conduct regular audits of denial cases to ensure compliance with policies and procedures.
- Train team members on best practices for denial management and quality assurance.
Skills and Qualifications
- 3-4 years of experience in healthcare denial management or quality assurance.
- Strong understanding of medical billing and coding processes.
- Proficiency in using healthcare management software and MS Office Suite.
- Excellent analytical skills with the ability to interpret data and generate reports.
- Strong communication and interpersonal skills to work effectively with cross-functional teams.
