Kelpei - Job Detail

Denials Manager

Vidsly Private Limited

We seek an experienced and highly motivated Denials Specialist to join our team. The Denials

Specialist will be responsible for handling denied claims, making outbound calls to insurance

payers, and resubmitting corrected claims. The ideal candidate should possess excellent

communication and problem-solving skills, have a strong understanding of medical billing and

coding, and be well-versed in denial management and appeals processes.

●Denial Identification and Analysis: Identify, categorize, and analyze denials and

underpayments from Explanation of Benefits (EOBs) and Electronic Remittance Advice

(ERAs).

● Claim Resubmission and Appeals: Correct and resubmit denied claims, or prepare and

submit appeals following payer guidelines and timelines.

● Payer Communication: Communicate with insurance companies to resolve issues leading

to denials and ensure accurate reimbursement.

● Preventative Action: Review denial trends and work with other RCM teams to implement

processes that can prevent future denials.

● Experience in analyzing and resubmitting Denials in multiple specialities (Denials due to

Medical Coding, Authorisation, etc).

1-6 years of prior experience in denials management, healthcare billing, or a related role.

● Strong understanding of medical billing processes payer requirements and CARC/RARC

codes.

● Excellent problem-solving and negotiation skills.

● Detail-oriented with strong analytical skills.

● Excellent communication skills, both written and verbal.

● Proficiency in using healthcare billing software and Microsoft Office Suite.

8 months ago