With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

WHAT YOU CAN EXPECT

• Analyze reports and use software to track, trend and identify root causes of denials; offer suggestions for process improvement to resolve denial issues, supported by documentation and data.

• Collaborate with other departments to align interdepartmental functioning, goals, and expectations.

• Ensure all clinical denials assigned to Clinicians, Patient Access and/or HIM denial staff are acknowledged in a timely manner and appropriate follow-up action is taken as defined by the respective policy.

• Conduct follow-up with insurance carriers, physicians, and other stakeholders that can validate and assist with actions and information needed in order to properly review, dispute or appeal denial until a determination is made to conclude the appeal.

• Ensure that follow-up responses on denied claims occur on a timely basis and adhere to contractually binding conditions.

• Resubmit overturned denials as warranted and monitor denial resubmissions for payment; resubmit claims using the denial program re-bill requests feature, ensuring all modifications to the account are reflected on the claim form.

• Ensure compliance with all state and federal billing regulations.

• Perform recoupments to include investigating claim and payment history to see if the appeal is warranted.

• Review rejected claims based on NPI denials.

Position will train remotely, and position is Work from home.

QUALIFICATIONS

• 1-year Prior Patient Accounting experience required.

• High School diploma required

TRAVEL IS REQUIRED: