Talent.com
Technical Denials Specialist
Technical Denials SpecialistBeacon Health System • Granger, IN
Technical Denials Specialist

Technical Denials Specialist

Beacon Health System • Granger, IN
Hace más de 30 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Summary

The Technical Denials Specialist plays a critical role in the health system’s revenue cycle operations by managing and appealing payer denials, with a strong focus on medical necessity, authorization, and eligibility issues. This position is responsible for identifying root causes, preparing and submitting appeals, and providing actionable feedback to key departments such as Patient Access and Registration. Through data analysis, reporting, and cross-functional collaboration, this role helps drive improvements that reduce denials and ensure optimal reimbursement.

MISSION, VALUES and SERVICE GOALS

  • MISSION: We deliver outstanding care, inspire health, and connect with heart.
  • VALUES: Trust. Respect. Integrity. Compassion.
  • SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Principal Duties and Responsibilities

  • Manages the end-to-end process for claim denials and appeals, including receipt, analysis, documentation, submission, and resolution with third-party payers.
  • Handles denials related to eligibility, medical necessity, prior authorization, non-coverage, and coding errors.
  • Performs root cause analysis to identify trends in denials and collaborates with internal stakeholders, particularly Patient Access and Registration, to provide feedback and recommend process improvements.
  • Submits timely and accurate appeals with appropriate supporting documentation and in accordance with payer guidelines and timelines.
  • Prepares and distributes monthly denial trend reports and dashboards to Revenue Cycle leadership, highlighting key findings, financial impacts, and suggested corrective actions.
  • Works closely with Revenue Cycle leadership to develop and implement preventative strategies aimed at reducing eligibility and authorization-related denials.
  • Recommends enhancements to claim edits, workflows, or registration practices to reduce recurring denial types.
  • Reviews payer correspondence and authorization requirements to assess financial risk and initiate retro-authorization requests when appropriate.
  • Maintains accurate records of all appeals activity and correspondence, ensuring compliance with internal policies and external regulations.
  • Ensures adherence to HIPAA, fraud and abuse laws, and organizational policies related to data security and confidentiality.
  • Maintains effective communication with payers and internal stakeholders, demonstrating professionalism, urgency, and accountability.
  • Engages in continuous learning to stay updated on payer requirements, industry changes, and revenue cycle best practices.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

  • Attends and participates in department meetings and is accountable for all information shared.
  • Completes mandatory education, annual competencies and department specific education within established timeframes.
  • Completes annual employee health requirements within established timeframes.
  • Maintains license/certification, registration in good standing throughout fiscal year.
  • Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
  • Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
  • Adheres to regulatory agency requirements, survey process and compliance.
  • Complies with established organization and department policies.
  • Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

  • Leverage innovation everywhere.
  • Cultivate human talent.
  • Embrace performance improvement.
  • Build greatness through accountability.
  • Use information to improve and advance.
  • Communicate clearly and continuously.

Education and Experience

  • The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a Bachelor’s degree (required) preferably in Health Administration, Business, Public Health, or a related field.
  • Minimum of 3 years of experience in hospital revenue cycle operations, with emphasis on denial management and appeals.

?Knowledge & Skills

  • Strong understanding of hospital registration, eligibility verification, and payer authorization processes.
  • Experience analyzing denial trends and providing actionable insights to cross-functional teams.
  • Proficient in Microsoft Office, hospital billing systems, and electronic health records (EHR).
  • Exceptional analytical, organizational, and written communication skills.
  • Ability to work independently, manage competing priorities, and collaborate effectively with clinical and non-clinical departments.

Working Conditions

  • Works in an office environment.

Physical Demands

  • Requires the physical ability and stamina to perform the essential functions of the position.
Crear una alerta de empleo para esta búsqueda

Technical Denials Specialist • Granger, IN

Ofertas similares

Dental Hygienist

Complete Family DentistryElkhart, IN, United States
A tiempo completo

Dental Hygienist to join our team.Support our mission to providing excellent dental care in the community and help us create more smiles and memorable experiences.Join a team that believes in teamw...Mostrar más

 • Oferta promocionada

General Dentist

GpacElkhart, Indiana, United States
A tiempo completo
Quick Apply

Experienced General Dentist – Solo Practice Opportunity in Elkhart, Indiana.This opportunity is ideal for a dentist who values.You’ll have full autonomy in treatment planning and the satisfaction o...Mostrar más

Registered Dental Hygienist

NORTHSIDE FAMILY DENTISTRY, LLCElkhart, Indiana, United States
A tiempo completo

Company Description Northside Family Dentistry is a private practice dental office with a tight bit group.Here we strive to provide the best experience to our patients in everything dental related....Mostrar más

 • Oferta promocionada

Pelvic Floor Physical Therapist (PT)

FYZICAL Therapy and Balance CentersGranger, IN, US
A tiempo completo
Quick Apply

Find your perfect career fit with FYZICAL, an innovative company that is committed to your growth and success, when you join us at our Granger, IN, location as our newest Pelvic Floor Physical Ther...Mostrar más

Locum Physician (MD/DO) - Hospitalist in Dowagiac, MI

LocumJobsOnlineDowagiac, MI, US
A tiempo completo

Doctor of Medicine | Hospitalist.Echo Locum Tenens | Sound Physicians .Competitive weekly pay (inquire for details) .LocumJobsOnline is working with Echo Locum Tenens | Sound Physicians to find a q...Mostrar más

 • Oferta promocionada

Gurley Leep Hyundai Dealership Technician

Gurley Leep Automotive FamilyMishawaka, IN, United States
A tiempo completo

Gurley Leep Ford is currently seeking an automotive service technician to join our team.Industry leading paid time off + vacation bonuses.Personal tool reimbursement every year.Medical/dental/visio...Mostrar más

 • Oferta promocionada

Field Technician

CennoxWarsaw, IN, US
A tiempo completo
Quick Apply

EXPERIENCED FIELD TECHNICIANS NEEDED IN WARSAW, IN Cennox is seeking an enthusiastic Field Technician to join our expanding Field Services division.We are looking for passionate, experienced field ...Mostrar más

General Foreperson

Asplundh Tree ExpertGoshen, IN, US
A tiempo completo

This position ensures the productivity of daily operations, working closely with management to determine recruiting/hiring needs, deadlines, and safety protocols to enforce among crews.The General ...Mostrar más

Registered Dental Hygienist

South Bend Dental & OrthodonticsGranger, IN, United States
A tiempo completo +1

Registered Dental Hygienist Opportunity – Our Best Life Companies.You will work alongside an experienced and supportive team dedicated to providing high-quality patient care in a friendly and upbea...Mostrar más

 • Oferta promocionada

Physician / Urology / Indiana / Locum Tenens / Urology Job

AMN HealthcareMishawaka, IN, United States
A tiempo completo

Job Description & Requirements Urology StartDate: ASAP Available Shifts: 8 Pay Rate: $550000.Advance your urology career in a dynamic practice.A not-for-profit, multi-hospital health system seeks a...Mostrar más

 • Oferta promocionada

Associate Dentist - Up to $50,000 Sign On Bonus

Pippin Dental & Braces - a Benevis companyDunlap, IN, United States
A tiempo completo

Please note: this position is located in Elkhart, IN.Work for a company that is truly making the world a happier place, one smile at a time! At Benevis, we create over a million smiles a year in th...Mostrar más

 • Oferta promocionada

Dental Hygienist

Heartland DentalElkhart, Indiana, United States
A tiempo completo

Overview Full-Time Position! Hello Elkhart!! Complete Family Dentistry is actively seeking a Dental Hygienist to join our team.Support our mission to providing excellent dental care in the communit...Mostrar más

 • Oferta promocionada

Donor Center Phlebotomist

American Red CrossGoshen, IN, United States
A tiempo completo

Please use Google Chrome or Mozilla Firefox when accessing Candidate Home.By joining the American Red Cross you will touch millions of lives every year and experience the greatness of the human spi...Mostrar más

 • Oferta promocionada

Urology

HealthEcareers - ClientMISHAWAKA, IN, USA
A tiempo completo

Job Description & Requirements.StartDate: ASAP Available Shifts: 8 Pay Rate: $550000.Advance your urology career in a dynamic practice.A not-for-profit, multi-hospital health system seeks a Urologi...Mostrar más

 • Oferta promocionada

Dentist

Decatur Family DentistryDecatur, MI
A tiempo completo
Quick Apply

Decatur Family Dentistry – General Dentist | Decatur, MI | Full Time.Are you looking for an opportunity to let your leadership & clinical skill sets shine while supporting a dedicated & growing tea...Mostrar más

Physical Therapist

ATI Physical TherapyElkhart, Indiana, United States
A tiempo completo

Overview Are you a Physical Therapist looking to thrive in a supportive, balanced environment? Join ATI, a leader in Outpatient Physical Therapy, where you’ll be part of a team redefining musculosk...Mostrar más

 • Oferta promocionada

Dental Sedation Assistant: Calm, Precise Patient Care

WizeHire, IncGranger, Indiana, United States
A tiempo completo

A dental surgery center is seeking a Dental Sedation Assistant in Granger, Indiana.The ideal candidate will have at least one year of dental assisting experience and a certification.Responsibilitie...Mostrar más

 • Oferta promocionada

Travel Physical Therapist (PT) - $2,146 per week in Cassopolis, MI

AlliedTravelCareersCassopolis, MI, US
A tiempo completo

AlliedTravelCareers is working with GetMed Staffing to find a qualified Physical Therapist (PT) in Cassopolis, Michigan, 49031!.GetMed Staffing is searching for a strong Physical Therapist to assis...Mostrar más