Central Health

Denial Management Lead supports leadership in monitoring tasks related to insurance follow-up and denial management functions. This position requires quick responses to patterns/trends seen in claims processing and the ability to providequick resolutions and/or bring attention to the direct supervisor. The Lead will help ensure denied claims are worked timely to ensure payment, and help education staff, providers and others on denial reasons to ensure denials are kept to aminimum.Tracks the status of all denied claims and unpaid claims from commercial and Medicaid payers. Helps ensure timely and complete follow up on unpaid or denied claims. Provides daily/weekly updates to Supervisor regarding assigned tasks. Helps ensure complete and accurate posting of all payer payments. Timely submits issues that caused unpaid claims to the attention of the Supervisor so so they are addressed andclaims are resubmitted in timely fashion. Complete complex tasks relating to insurance verification,...

Under general supervision, refers, enrolls and/or assists customers in obtaining appropriate local or state funded healthcare coverage, and assists customers in resolving complex problems and complaints. Performs out stationed eligibility duties including submitting, tracking and troubleshooting State program applications.Essential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):• Interview applicants in a professional and courteous manner to obtain appropriate demographic and household information needed in order to screen clients for appropriate healthcare coverage programs• Accurately enter client data, and collect, verify and scan appropriate documents into the eligibility database according to Eligibility Policies and Procedures.• Accurately apply the Eligibility Policies and Procedures to determine client eligibility and enroll eligible clients into the appropriate local and grant...