Aya Healthcare has an exciting 26 week contract as a Denials Specialist located in San Leandro, CA!
Job Details:
JOB TITLE: Denials Specialist
CONTRACT DURATION: 26 week contract with possibility of extending
SHIFT: M-F 7:30-4pm
LOCATION: San Leandro, CA- hybrid
ONBOARDING TIME: Expect 2-3 weeks from offer acceptance to start date.
PAY: $28-31hr
DETAILS ABOUT THE DENIALS SPECIALIST
High skill set in Medi-Cal
Qualifications Minimum Experience:
3 - 5 years of experience in a hospital business environment performing billing and/or collections. OR two years of experience in a Revenue Cycle area within the Alameda Health System.
Required Education: High school diploma or equivalent education.
Job Summary
The PFS Denial Specialist is responsible for validating dispute reasons following Explanation of Benefits (EOB) / Remittance Advice review, escalating payment variance trends and/or issues to management, and generating appeals for denied and/or underpaid claims.
Knowledge, Skills and Abilities
* To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* Act in an appropriate and professional manner as defined by the company’s Standards of Behavior, Policy and Procedures, and Scope of Services.
* Current office administrative practices and procedures.
* Establish and maintain effective working relationships with a variety of individuals from various socioeconomic, ethnic and cultural backgrounds.
* Excellent communication skills, both written and verbal; advanced business letter writing skills to include correct use of grammar and punctuation.
* Intermediate computer skills including thorough understanding of the EHR system, Microsoft Office (Word, Outlook, Excel).
* Intermediate knowledge of CPT and ICD-10 codes, coding and medical terminology.
* Intermediate knowledge of insurance claims and insurance terminology.
* Intermediate knowledge of UB-04 and Explanation of Benefits (EOB) interpretation.
* Intermediate understanding of Explanation of Benefits form (EOB), Managed Care Contracts, Contract Language and Federal and State Requirements.
* Role model AHS Standards of Behavior.
* Should have a good understanding of payer contract language, and how to apply language to reimbursements.
* Use independent judgment and initiative within established policies and procedures.
AYA DELIVERS…
· Front-of-the-line access to exclusive jobs at thousands of healthcare facilities nationwide.
· A robust team to support you every step of the way to ensure you start on time, have accurate payroll and an exceptional experience.
· A credentialing specialist to streamline the entire compliance process.
· And of course, you get the usual benefits such as:
o Premium medical, dental, vision and life insurance beginning day one of your assignment.
o Pay listed above includes taxable wages and tax-free expense reimbursements, when applicable.
Aya Healthcare is an Equal Opportunity Employer and encourages all to apply!
Pay: $28.00 - $31.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Vision insurance
Application Question(s):
- Do you have 3 years experience working with Medi-Cal?
- Do you have3 - 5 years of experience in a hospital business environment performing billing and/or collections. OR two years of experience in a Revenue Cycle area within the Alameda Health System?
Ability to Commute:
- San Leandro, CA (Required)
Work Location: Hybrid remote in San Leandro, CA
