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Company: ACRO STAFF
Contact Name: DAVE

Job Details: Denials Prevention - Hospital Claims Date: May 19 2020

Job Reference: 3248
Job Category: Medical Jobs [ View All Medical Jobs Jobs ]
Company Type Recruiter
Employment type: Full Time
Degree: High School
Experience: 3 years
Location: Miami, Florida, 33102
Job Skills: Denials Prevention - Hospital Claims
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Job Description

Analyze monthly reports by trends, hospital, payor, and reason in order to identify operational issues causing denials
Work with all applicable departments and staff to develop processes to reduce and prevent future denials
Review managed care contracts, hospital billing statements/bills, and insurance denials
Communicate with hospital and payor personnel concerning all issues relating to denials
Present initiatives and results at meetings
Maintain confidentiality of information in compliance with company policy and HIPAA
Maintain regular contact with necessary parties including payors, clients, managers, and other company personnel
Build strong, lasting relationships with clients, payors and company personnel
Attend client, department and company meetings
Comply with federal and state laws, company and department policies and procedures
All other duties as assigned


College degree or diploma from school of nursing - must be RN
Clinical nursing experience working in hospital environment, preferably in ER, ICU, Med-Surg or Transplant Unit
Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook
Excellent interpersonal and communication skills
Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division
Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form
Ability to present written routine correspondence (in English)
Ability to define problems, collect data, establish facts and draw valid conclusions
Strong customer service orientation
Excellent interpersonal and communication skills
Strong team player
Commitment to company values
Ability to travel.




1. College degree or diploma from school of nursing.
2. RN.
3. Clinical nursing experience working in hospital environment, preferably in ER, ICU, Med-Surg or Transplant Unit.
4. Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division.
5. Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form.

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