About the Job
Key Responsibilities:1. Utilize Laboratory Information System (LIS) and Waystar clearinghouse tools to research, track, and resolve claim denials and rejections.
2. Analyze insurance payer denial reasons and take appropriate, timely actions such as claim correction, documentation submission, resubmission, or appeal.
3. Clarify denial causes and ensure resolution pathways are accurate and efficient.
4. Maintain a working knowledge of payer-specific rules, denial trends, rejection codes, and resolution timelines.
5. Correct and resubmit rejected or denied claims quickly and within company policy and guidelines.
6. Document claim status, payer communication, and resolution steps clearly and accurately in the billing and clearinghouse systems.
7. Identify and report recurring denial trends and system or process breakdowns to Revenue Cycle leadership for further action.
8. Collaborate with the internal teams to resolve registration or demographic errors impacting claims.
9. Participate in performance review meetings and denial trend analysis to ensure continuous improvement in denial prevention strategies.
10. Meet established KPIs for productivity, turnaround time, and quality assurance.
11. Ensure all actions are performed in full compliance with HIPAA and organizational policies.
12. Assist with other billing, reconciliation, or appeals tasks as assigned.
Number of Openings
1 openingsSkills
English Proficiency (Spoken), English Proficiency (Written)
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