Denials Management Specialist

At Houston Methodist, we are looking for a highly motivated and organized individual to join our team as a Denials Management Specialist. This is a great opportunity for someone with a passion for patient care and a knack for problem solving. In this role, you will be responsible for ensuring accurate and timely reimbursement of claims and identifying and resolving claims issues.To be successful in this role, you will need a high school diploma or equivalent, a minimum of two years of experience in a healthcare setting, and experience working with insurance denials and appeals. You should have strong organizational and communication skills, as well as the ability to work independently and prioritize tasks. A working knowledge of medical terminology and coding is also preferred. Above all, you must be a team player with a drive to contribute to the success of Houston Methodist.

Responsibilities:

1. Manage the timely reimbursement of claims and ensure accuracy of claims.
2. Analyze and resolve any claims issues.
3. Communicate with insurance companies regarding denials and appeals.
4. Prioritize tasks and work independently.
5. Maintain professional relationships with payers, providers, and other internal/external stakeholders.
6. Utilize medical terminology and coding knowledge.
7. Monitor and report on denials trends.
8. Prepare and submit accurate and timely appeals to insurance companies.
9. Stay up-to-date with industry regulations and changes.
10. Provide guidance and support to staff members.

According to JobzMall, the average salary range for a Denials Management Specialist in Houston, TX, USA is $44,000 - $60,000 per year. This range may vary depending on experience, qualifications, and other factors.

Houston Methodist Hospital is the flagship quaternary care hospital of Houston Methodist academic medical center. Located in the Texas Medical Center in Houston, Texas, Houston Methodist Hospital was established in 1919 during the height of the Spanish influenza epidemic as an outreach ministry of Methodist Episcopal Church. Houston Methodist comprises eight hospitals, an academic institute, a primary care group, and more than 300 locations throughout greater Houston. The hospital has consistently ranked as "One of America's Best Hospitals" according to U.S. News & World Report. The hospital has earned worldwide recognition in multiple specialties including cardiovascular surgery, cancer, epilepsy treatment and organ transplantation. Houston Methodist System changed its official name to Houston Methodist in 2013.