Denial Management Specialist at Altru Health System

Everything We Do Is Underscored By A Why — And That Why Is One Another. Location

Altru Health System PO Box 6002 Grand Forks, ND 58201 Pay Range: $17.07 - $25.60

Summary

The Denial Management Specialist is responsible for managing and filing appeals to reverse denials, collaborating with departments to resolve issues and identify trends, and staying updated on payer guidelines and requirements for denials and appeals. The position involves monitoring RAC accounts for adjustments, analyzing denial trends, and exhausting all appeal efforts according to payer guidelines. The role also includes providing feedback to leadership, participating in continuing education on payer policies, and ensuring accurate account adjustments.

Effective communication, confidentiality, and adherence to privacy standards are essential aspects of this position. Essential Job Functions: Manages and file appeals to reverse denials wherever possible. Works on assigned denials and appeals by collaborating with departments to resolve issues and identify trends.

Stays updated on payer guidelines and requirements for denials and appeals. Monitors RAC accounts for AB rebills and post recovery or denial adjustments as needed. Identifies and address issues from denials to prevent future claim problems and analyzes denial trends and issues as assigned.

Requirements

This position requires proficiency in reading, writing, and speaking English to ensure effective communication in the workplace and with patients, families, and team members.

• Physical Demands: • Sit: Frequently (34-66%) • Stand: Occasionally (5-33%) • Walk: Occasionally (5-33%) • Stoop/Bend: Rarely (1-4%) • Reach: Frequently (34-66%) • Crawl: Not Applicable • Squat/Crouch/Kneel: Rarely (1-4%) • Twist: Occasionally (5-33%) • Handle/Finger/Feel: Continuously (67-100%) • See: Continuously (67-100%) • Hear: Continuously (67-100%) Weight Demands: • Lift -Floor to Waist Level: Sedentary (<10 pounds) • Carry: Sedentary (<10 pounds) • Push/Pull: Sedentary (<10 pounds) • Slide/Transfer: Not Applicable Working Conditions: • Indoor: Continuously (67-100%) • Outdoor: Not Applicable • Extreme Temperature: Not Applicable Driving Requirement Definitions: Professional Drivers: Persons who drive as their main responsibility OR transport passengers or hazardous materials. Frequent Drivers: Persons whose main responsibility is not driving, but drive daily or almost daily.
• Occasional Drivers: Persons who drive from once per month to as frequently as once per week. Infrequent Drivers: Persons who are generally not expected to drive. Driving Requirement for this position: Infrequent Driver Reference ID: R7699 Making a real difference. For one another. To take the best care of our patients and community — including friends, family, and neighbors — we need people who are committed to growth, excellence, and one another. At Altru, you’ll find a culture where support and teamwork are at the heart of what we do. You’ll have opportunities to advance your skills, work with the latest technologies, experience the fulfillment that comes from giving back, and take your career wherever you want it to go. Join our team and be a part of a small community with a big heart. Altru offers a comprehensive

Benefits

• package to its full- and part-time employees. Excellent

Benefits

• include a health plan and 401(k) retirement plan. Other

Benefits

• include a dental plan, vision plan, life and disability insurance, education assistance, paid time off (PTO)