Introduction
To heal, to teach, to discover and to advance the health of the communities we serve.
To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.
Overview
City/State:
Bronx, New York
Grant Funded:
No
Department:
NoMgr
Work Shift:
Day
Work Days:
MON-FRI
Scheduled Hours:
8:30 AM-5 PM
Scheduled Daily Hours:
7.5 HOURS
Pay Range:
$49,920.00-$62,400.00
Responsibilities
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.
Requirements
- 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 PowerPoint 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 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.
