Denial Clerk, Full Time at Hialeah Hospital in Hialeah, FL

POSITION SUMARY

The denial clerk supports the denial management process, focusing on handling denied insurance claims, ensuring accurate documentation, and coordinating with multiple areas to resolve payment issues.

KEY RESPONSIBILITIES

• Gather and record information from denied insurance claims.
• Keep track of all new denials and updates patient account system with correspondence and additional pertaining documentation.
• Use the EHR system to retrieve medical records, itemized bills and payer correspondence.
• Use the billing platform to view and print UBs, check claim status, such as rejections.
• Knowledgeable in different payer portals to view and retrieve payments and denials.
• Send documentation, appeals, and medical records.
• Follow up with insurance on appeals and/or reconsiderations.
• Other duties as assigned.

EDUCATION, QUALIFICATIONS AND EXPERIENCE

• High school diploma or equivalent.
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Organizational and time management skills.
• Strong written and verbal communication skills.
• Detail oriented, courteous, and results-driven.