QA/Denial Analyst
Arkana Labs Arkana Labs Little Rock, AR Little Rock, AR Full-time Full-time Estimated:
$65.
4K - $82.
9K a year Estimated:
$65.
4K - $82.
9K a year 7 days ago 7 days ago 7 days ago Description/Job Summary POSITION
Summary:
The QA Denial Management Specialist will be responsible for timely and accurate correction to denied claims based on root cause analysis and configuration/maintenance of the denial management module within the Essential Functions Statement(s) Appeal, reprocess, and send reconsiderations on denied claims according to explanation of denial and root cause analysis Follow up on outstanding appeals, reprocesses and reconsiderations Report insurance policy changes found during root cause analysis to the RCM Quality Assurance Team Lead Report findings of root cause analysis and any recommended solutions to denials based on root cause analysis to the RCM Quality Assurance Team Lead Create, update, maintain configurations for remittance sets, crossovers, and appeal packages within the billing system Root cause insurance related overpayment and refund requests from payers Request refunds through the billing software when necessary with all proper supporting documentation being available to view by accounts payable Detailed documentation in all accounts that are updated and worked Organize and store all account letters in appropriate network folders Assess processes, duties, tasks and recommend updates to improve processes and procedures as needed Maintain basic working knowledge of other Quality Assurance Team Functions (Payer Enrollment and Collections) Other duties as assigned Skills and Abilities Proven track record of process improvement to drive accuracy and efficiency Evidenced problem-solver Strong leadership skills Excellent verbal and written communication skills Detail-oriented and analytical thinker Demonstrated ability to project manage (i.
e.
scheduling, critical thinking, communication) Ability to prioritize and maintain composure in stressful times Qualifications Five years of medical billing experience Proficient with various software applications (Outlook, Excel, Word), computer systems, web-based applications, and third-party portals Knowledge of commercial and government payers Benefits Competitive pay 401(k) with immediate eligibility and match Generous PTO Health insurance options for you and your family Monthly in office chair massages and employer sponsored lunches Company-paid Life insurance Company-paid LTD Coverage Affordable Vision and Dental plans Flexible Spending Account or Health Savings Account availability Wellness plan Appeal, reprocess, and send reconsiderations on denied claims according to explanation of denial and root cause analysis Follow up on outstanding appeals, reprocesses and reconsiderations Report insurance policy changes found during root cause analysis to the RCM Quality Assurance Team Lead Report findings of root cause analysis and any recommended solutions to denials based on root cause analysis to the RCM Quality Assurance Team Lead Create, update, maintain configurations for remittance sets, crossovers, and appeal packages within the billing system Root cause insurance related overpayment and refund requests from payers Request refunds through the billing software when necessary with all proper supporting documentation being available to view by accounts payable Detailed documentation in all accounts that are updated and worked Organize and store all account letters in appropriate network folders Assess processes, duties, tasks and recommend updates to improve processes and procedures as needed Maintain basic working knowledge of other Quality Assurance Team Functions (Payer Enrollment and Collections) Other duties as assigned Proven track record of process improvement to drive accuracy and efficiency Evidenced problem-solver Strong leadership skills Excellent verbal and written communication skills Detail-oriented and analytical thinker Demonstrated ability to project manage (i.
e.
scheduling, critical thinking, communication) Ability to prioritize and maintain composure in stressful times Qualifications Five years of medical billing experience Proficient with various software applications (Outlook, Excel, Word), computer systems, web-based applications, and third-party portals Knowledge of commercial and government payers Competitive pay 401(k) with immediate eligibility and match Generous PTO Health insurance options for you and your family Monthly in office chair massages and employer sponsored lunches Company-paid Life insurance Company-paid LTD Coverage Affordable Vision and Dental plans Flexible Spending Account or Health Savings Account availability Wellness plan.
Estimated Salary: $20 to $28 per hour based on qualifications.
$65.
4K - $82.
9K a year Estimated:
$65.
4K - $82.
9K a year 7 days ago 7 days ago 7 days ago Description/Job Summary POSITION
Summary:
The QA Denial Management Specialist will be responsible for timely and accurate correction to denied claims based on root cause analysis and configuration/maintenance of the denial management module within the Essential Functions Statement(s) Appeal, reprocess, and send reconsiderations on denied claims according to explanation of denial and root cause analysis Follow up on outstanding appeals, reprocesses and reconsiderations Report insurance policy changes found during root cause analysis to the RCM Quality Assurance Team Lead Report findings of root cause analysis and any recommended solutions to denials based on root cause analysis to the RCM Quality Assurance Team Lead Create, update, maintain configurations for remittance sets, crossovers, and appeal packages within the billing system Root cause insurance related overpayment and refund requests from payers Request refunds through the billing software when necessary with all proper supporting documentation being available to view by accounts payable Detailed documentation in all accounts that are updated and worked Organize and store all account letters in appropriate network folders Assess processes, duties, tasks and recommend updates to improve processes and procedures as needed Maintain basic working knowledge of other Quality Assurance Team Functions (Payer Enrollment and Collections) Other duties as assigned Skills and Abilities Proven track record of process improvement to drive accuracy and efficiency Evidenced problem-solver Strong leadership skills Excellent verbal and written communication skills Detail-oriented and analytical thinker Demonstrated ability to project manage (i.
e.
scheduling, critical thinking, communication) Ability to prioritize and maintain composure in stressful times Qualifications Five years of medical billing experience Proficient with various software applications (Outlook, Excel, Word), computer systems, web-based applications, and third-party portals Knowledge of commercial and government payers Benefits Competitive pay 401(k) with immediate eligibility and match Generous PTO Health insurance options for you and your family Monthly in office chair massages and employer sponsored lunches Company-paid Life insurance Company-paid LTD Coverage Affordable Vision and Dental plans Flexible Spending Account or Health Savings Account availability Wellness plan Appeal, reprocess, and send reconsiderations on denied claims according to explanation of denial and root cause analysis Follow up on outstanding appeals, reprocesses and reconsiderations Report insurance policy changes found during root cause analysis to the RCM Quality Assurance Team Lead Report findings of root cause analysis and any recommended solutions to denials based on root cause analysis to the RCM Quality Assurance Team Lead Create, update, maintain configurations for remittance sets, crossovers, and appeal packages within the billing system Root cause insurance related overpayment and refund requests from payers Request refunds through the billing software when necessary with all proper supporting documentation being available to view by accounts payable Detailed documentation in all accounts that are updated and worked Organize and store all account letters in appropriate network folders Assess processes, duties, tasks and recommend updates to improve processes and procedures as needed Maintain basic working knowledge of other Quality Assurance Team Functions (Payer Enrollment and Collections) Other duties as assigned Proven track record of process improvement to drive accuracy and efficiency Evidenced problem-solver Strong leadership skills Excellent verbal and written communication skills Detail-oriented and analytical thinker Demonstrated ability to project manage (i.
e.
scheduling, critical thinking, communication) Ability to prioritize and maintain composure in stressful times Qualifications Five years of medical billing experience Proficient with various software applications (Outlook, Excel, Word), computer systems, web-based applications, and third-party portals Knowledge of commercial and government payers Competitive pay 401(k) with immediate eligibility and match Generous PTO Health insurance options for you and your family Monthly in office chair massages and employer sponsored lunches Company-paid Life insurance Company-paid LTD Coverage Affordable Vision and Dental plans Flexible Spending Account or Health Savings Account availability Wellness plan.
Estimated Salary: $20 to $28 per hour based on qualifications.
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